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KMID : 0365719960120010099
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Journal of Pusan Surgical Society
1996 Volume.12 No. 1 p.99 ~ p.102
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A Laparoscopic Cholangiography Using Modified Intravenous Catheter
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Abstract
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Summary : This report describes an easy and inexpensive application of the Modified Intravenous Catheter for Cholangiography (MICC) to perform cholangiography during laparoscopic cholecystectomy. Between July of 1993 and October of 1996, we
treated
17
patients with symptomatic gallstones using this apparatus. The MICC is made with a 32 cm 20 gauge intravenous catheter (Cavafix by B. Braun Melsungen AG) and a 18 gauge needle body without its hub and tip. The 18 gauge needle body is fixed 1.5 cm
from
the tip of the catheter using a cyanoacrylate adhesive. During a routine laparoscopic cholecystectomy, a 12-16 gauge needle is pushed into the peritoneal cavity. Then, the MICC is inserted through this needle and inserted into the cystic duct
with
laparoscopic forceps, aided by saline infusion to decrease the resistance in the cystic duct. The MICC is held in place by placing a metal clip over the 18 gauge needle body while cholangiography is performed. The cholangiography was performed
successfully in all the patients in this study. The MICC catheter tip was more reactible, in passing the spiral valve, than standard cholangiographic catheter. In four patients, the cholangiography revealed stone in either the commom bile duct or
the
intrahepatic duct. In two of these patient the stones were removed using a stone basket wire through 40 cm 14-16 gauge intravenous catheter, just after the cholangiography. We conclude that the Modified intravenous Catheter for Cholangiography
(MIC) was
successfully used for cholangiography during laparoscopic cholecystectomy. Furthermore, a stone basket wire through a 14-16 gauge intravenous catheter, was used successfully to remove stones from the common bile duct.
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