THE PERFECT STORM: LAPAROSCOPIC TRANSCHOLEDOCHAL BILE DUCT EXPLORATION FOR BILE DUCT BEZOAR IN ADVANCED CIRRHOSIS WITH PORTAL HYPERTENSION

Transcholedochal laparoscopic bile duct exploration is a challenging procedure. Advanced cirrhosis with portal hypertension is associated with unique set of challenges not limited to increased risk of bleeding and fragile liver. Bile duct phytobezoar is an extremely rare finding in which lithotripsy is ineffective.
This case is an example of a challenging biliary patient with cirrhosis, portal hypertension with a 6cm bile duct phytobezoar.
The video shows the surgical approach, handling of the liver, anatomical challenges, surgical planning and exit strategy, and technical aspects of this extremely rare case and challenging operation, applicable to other complicated biliary procedures.