Evaluation of the use of the Ambu_aScope 2TM in laparoscopic common bile duct exploration

Abstract

Introduction Cholelithiasis is a common disease, occurring in 5–22% people in the western countries. The management of common bile duct stones (CBDS) could be adopted in two main lines. The first line is through laparoscopic cholecystectomy and common bile duct (CBD) exploration in one session, the other is endoscopic retrograde cholangiopancreatography then laparoscopic cholecystectomy. In this study we evaluate a novel device with cases of laparoscopic CBD exploration which is Ambu_aScope 2TM which is mainly used as a bronchoscope in cases of difficult intubation, however we evaluate the capability of such device to perform accurately in CBD exploration. Aim of the work This is a prospective randomized study to investigate the outcome of using Ambu_aScope 2TM in laparoscopic CBD exploration in the management of patients with CBDS. Patients and methods Equipment: a recent case report described the use of the Ambu_aScope 2TM in an open CBD exploration. They showed that they were able to perform a successful procedure in their patient. Patient population: all patients who were scheduled for laparoscopic CBD exploration, in whom Ambu_aScope 2TM was used were included in our study during the period from October 2016 till February 2018. Results Eighteen patients underwent laparoscopic CBD exploration. Two patients converted to open due to difficult stone extraction that was distal and impacted and the other was due to sever adhesions from previous acute cholecystitis. All cases were done using the Ambu_aScope through choledotomy in CBD. The Ambu_aScope was used to visualize the CBD and extract the stones either by Fogarty's catheter done in nine cases or dormia basket in the rest of cases. Conclusion Laparoscopic CBD exploration is considered one of the corner stones in the CBDS management. The Ambu_aScope 2TM was approved and satisfactory to the operating surgeons as regarding the handling of the instrument, orientation, quality of image, and feasibility of stone extraction through the working port.