PMC3862908_01
Intraoperative cholangiography via the punctured gall bladder (asterisk) showing complete obstruction of common bile duct (arrow) with dilatation of cystic duct and hepatic duct.
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Fig1
After laparoscopically controlled (umbilical trocar, 3 mm) transabdominal puncture of the gall bladder, intraoperative cholangiography revealed complete obstruction of the common bile duct (Figure  1).
Intraoperative laparoscopic views of the gall bladder (asterisk) and liver surface (a), the gall bladder being grasped and pulled to the trocar (b), after suturing the gall bladder to the fascia (c), arrow marking the trocar site.
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Fig2
Therefore, the gall bladder was grasped through a second 3 mm port in the right upper abdomen and pulled out at the port site, sutured to the fascia extracorporally, and an indwelling 4 French Certofix catheter was positioned into the infundibulum (Figure  2).
Postoperative course of stool pigmentation.
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Fig3
After 3 days, pigmentation of the stool was observed (Figure  3) and a contrast study via the catheter at day 8 revealed complete resolution of the plug and free passage of contrast medium into the duodenum (Figure  4).
Contrast study via the gall bladder catheter after 8 days of irrigation showing narrow bile ducts and free passage into the duodenum, arrow marking the common bile duct, asterisk marking the catheter placed into the gall bladder.
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Fig4
After 3 days, pigmentation of the stool was observed (Figure  3) and a contrast study via the catheter at day 8 revealed complete resolution of the plug and free passage of contrast medium into the duodenum (Figure  4).