Question

Evelyn bean, 52 years of age, is admitted to the same-day surgery unit for an elective laparoscopic cholecystectomy. the patient presents with jaundice of the skin and sclera. the patient's urine is dark and the patient stated that she has clay-colored stools. he stated she has occasional colicky pain in her right upper quadrant of her abdomen radiating to her back. the patient had pre admission testing 1 week ago and the results are on the patient's chart. the record of patient education and an informed written consent are also on the chart. (learning objective 2 and 3)
a. what additional procedure will be performed if the common bile duct is obstructed by a gallstone

Answer 1

The patient can be subjected to intraoperative cholangiography wherein a stent in the bile duct will be placed and a radiopaque dye will be injected. X-rays will be taken. This is to locate the level of obstruction and to confirm if there is a common bile duct obstruction. In extracting stones, the surgeon can prefer doing an endoscopic retrograde cholangiopancreatography or ERCP and perform basket extraction of the common bile duct stone; or to surgically remove the sphincter of Oddi to allow easy passage of the stones.