FIELD: medicine.
SUBSTANCE: retrograde dilator is inserted through a defect of an extrahepatic bile duct into the left hepatic duct to the round ligament of the liver. That is followed by visually controlled opening of the peritoneum and the left hepatic duct at the dilator tip. A perforated drain tube is inserted into the left hepatic duct following the removed dilator to the level below the defect of the extrahepatic duct. The proximal end of the drain tube is brought out through an additional incision of the anterior abdominal wall onto the skin and fixed. The retrograde dilator is inserted through the defect of the extrahepatic duct into the left hepatic duct to the round ligament of the liver. That is followed by visually controlled opening of the peritoneum and the left hepatic duct at the dilator tip. The perforated drain tube is brought backward following the removed dilator. The proximal end of the drain tube is brought out through the additional incision of the anterior abdominal wall onto the skin and fixed.
EFFECT: method enables using the common kit of instruments to reduce intraoperative injuries when inserting the drain tube; the drain tube is isolated completely from the abdominal cavity; the tube is loosely removed after the extraperitoneal decompression of the bile ducts.
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Authors
Dates
2014-08-10—Published
2013-03-20—Filed