STEP 5Cholangiography

Lateral retraction of Hartmann's pouch is maintained by a grasper, this time coming from the subxiphoid port.

The cystic duct is incised through the right (A). The cystic valve can occasionally make this difficult.

A No. 4 ureteric catheter with an end hole is inserted through the Olsen-Reddick cholangiogram clamp into the cystic duct and the clamp closed around the duct (B).

Operative cholangiography is then performed with aid of C-arm fluoroscopy. Cholangiography confirms the biliary anatomy and reveals the common duct stones, allowing laparoscopic duct exploration.

Olsen Cholangiogram Clamp

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