Laparoscopic micro-incision technique at cystic duct confluence for pediatric choledocholithiasis management: A case report

Figure 4 Laparoscopic micro-incision technique applied at the cystic duct confluence during laparoscopic common bile duct exploration procedure. A: Pre-ligating and applying traction to the distal cystic duct with a 4-0 silk suture, the Calot’s triangle was exposed, and a microincision was made at the cystic duct-common bile duct (CBD) confluence (white arrow); B: Choledochoscope insertion through the micro-incision at cystic duct confluence; C: During choledochoscopy, stones were identified in the middle and lower segments of the CBD, which were subsequently extracted using a basket retrieval technique; D: Upon reinsertion of the choledochoscope, no stones were observed in the distal and middle segments of the CBD; E: Upon repositioning the choledochoscope, no stones were identified in the proximal segment of the CBD.