Choledochal exploration is a level 4 procedure.
Indications for choledochotomy include primary choledocholithiasis, choledochal stones secondary to gallbladder stones, benign stenosis of the bile duct and biliary pancreatitis.
Contraindications to choledochotomy include large stones in the bile duct, low confluence of the cystic duct and the common bile duct and combined intrahepatic bile duct stones.
Procedure: In the supine position, a transrectus abdominis incision is usually made in the right upper abdomen to expose a good view of the common bile duct, which is incised and then explored. If stones are present, etc., they can be removed. If there is lower choledochal stenosis, lower choledochal dilatation can be performed at the same time.
Regarding the exploration of the common bile duct, it is necessary to take into account the specific situation of the patient and treat under the guidance of a specialized doctor.