PMC3015376_01
ERCP unable to pass the stent because there is a clip across the common duct.
jsls-4-2-163-g01.jpg
PMC3015376_01_jsls-4-2-163-g01.jpg
F1
ERCP by gastroenterology was performed, but the surgeons were unable to insert a stent (Figure 1).
Video laparoscopic anatomical photograph of the round and falciform ligament so close to the common bile duct it is able to overlap. With its own blood supply, it makes a perfect autologus graph.
jsls-4-2-163-g02.jpg
PMC3015376_01_jsls-4-2-163-g02.jpg
F2
It was sutured with proline 5-0 near the injury of the common bile duct, side-to-side to the round and falciform ligament circumferencial patching a "T" tube No. 10 French placed (Figure 2) and reinforced using 5-0 chromic interrupted sutures and tacked down with omentum (Figure 3).
Graphic of the side-to-side anastomosis using proline 5-0, running suture stented with a "T" tube no. 10 French, in this particular patient.
jsls-4-2-163-g03.jpg
PMC3015376_01_jsls-4-2-163-g03.jpg
F3
It was sutured with proline 5-0 near the injury of the common bile duct, side-to-side to the round and falciform ligament circumferencial patching a "T" tube No. 10 French placed (Figure 2) and reinforced using 5-0 chromic interrupted sutures and tacked down with omentum (Figure 3).
ERCP after five months without stenosis. Patient asymptomatic.
jsls-4-2-163-g04.jpg
PMC3015376_01_jsls-4-2-163-g04.jpg
F4
Subsequently, the "T" tube was removed three months postoperatively, and ERCP after five months showed a common duct without stenosis as presented in the X-ray films (Figure 4).