General Surgery · HPB

Common Bile Duct Exploration (Open)

OPERATION: Open Common Bile Duct Exploration with T-Tube Drainage
ANAESTHETIC: General anaesthesia
ANTIBIOTICS: IV antibiotics at induction including biliary cover
POSITION: Supine. Radiolucent table for intraoperative cholangiography.

INDICATION:
Common bile duct stones — identified at [open cholecystectomy with intraoperative cholangiography / laparoscopic cholecystectomy with conversion to open / palpable stones in CBD at open cholecystectomy]. ERCP not feasible or stones not amenable to endoscopic extraction. [Preoperative LFTs / USS / MRCP findings].

PROCEDURE:
WHO Checklist performed. Open cholecystectomy performed in standard fashion. Cystic artery and duct ligated and divided. Gallbladder removed. CBD dissected and exposed on its anterior wall for 2-3 cm — lateral walls avoided to preserve blood supply.