Dictated by Donald E. Wenner, MD FACS
70 year old female with intermittent jaundice, and recurrent attacks of RUQ pain. Gall bladder ultrasound showed cholelithiasis and borderline dilation of CBD. Laboratory studies showed bile 1.9, SGOT 128, SGPT 176, alkaline phosphatase 207. Patient was taken to surgery for LC with IOC. Cholangiogram demonstrated a single stone in a modestly dilated CBD. An anterior choledochotomy was made and, using a balloon catheter, an oblong 4x9mm stone was retrieved from the CBD. The MIG and 3.2mm choledochoscope were used to inspect the proximal and distal bile ducts. No additional stones were discovered, and the choledochoscope would readily pass into the duodenum through the ampulla. A T-tube was placed, and the gall bladder was then removed. T-tube cholangiogram demonstrated clearance of the CBD and good flow into the duodenum. The operation took 1' 58". The patient was discharged home on postoperative day two. Again there was no postoperative pancreatitis.