Laparoscopic transcystic exploration of the common bile duct using a 9 Fr catheter

Objective: This study aimed to explore the clinical efficacy of performing a laparoscopy with a 9Fr disposable pancreaticobiliary catheter in diagnosing and treating common bile duct stones. Methods: Duodenoscopy was performed in 66 patients between January 2020 and January 2024 at our institution. Clinical indicators were analyzed, and postoperative treatment effects were monitored. Results: A total of 66 patients underwent surgery, including 50 with secondary common bile duct stones and 16 with primary common bile duct stones. The operative time ranged from 80 to 290 min (138.79 ± 36.86 min). Intraoperatively, blood loss volume ranged from 5 to 50 mL (13.03 ± 7.06 mL). The average postoperative length of hospital stay was 9.95 ± 2.43 days. The success rate of stone removal was 98.5%. One patient had the stone enter the pancreatic duct during the removal process, resulting in failed stone removal. Postoperative complications occurred in 7 patients. Three patients had fever and improved after antibiotic treatment. One patient had acute gastric dilation and was given gastrointestinal decompression. One patient had abdominal pain, which was likely caused by bile entering the pelvic cavity. The patient improved after symptomatic supportive treatment and traditional Chinese medicine physical therapy. Two patients had complications of biliary pancreatitis. Conclusion: Laparoscopy using a 9Fr disposable pancreaticobiliary catheter could be useful diagnosing and treating common bile duct microstones. These are preliminary results from a descriptive case series.