PMC5636918_01
Endoscopic retrograde cholangiography (ERCP) showing the guide wire past the cut-off area at the middle of common bile duct. The intrahepatic ducts are not opacified.
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F1
There was complete cutoff of contrast at the middle third of the CBD (Figure 1).
Single-operator cholangioscopy (SOC) showing the site of transected common bile duct.
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F2
The bile duct was explored endoscopically using the SOC, confirming the mid-CBD surgical injury (Figure 2).
ERCP showing the guide wire lassoed with SOC assistance. This image shows the duodenoscope (white arrow), the SOC (yellow arrow), the right percutanous drain (black arrow), and the guide wire lassoed from the left percutanous biliary catheter (red arrow).
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F3
The Spyglass probe was advanced from the injury site through the subhepatic fossa into the liver hilum, and both the right external drain and snare were seen (Figure 3).
SOC showing the guidewire lassoed under direct visualization, with the snare (yellow arrow) and the wire passed through cholangioscope (red arrow).
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F4
The guide wire was passed through the cholangioscope and successfully lassoed by the loop snare (Figure 4).
Scout radiograph film showing a fully covered, self-expandable metalic stent with the right and left internal drain in place.
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F5
The biliary stents and percutaneous drains were in good positions at the end of the procedure (Figure 5).