A 43-year-old woman undergoes open cholecystectomy. Intraoperative cholangiogram revealed multiple stones in the CBD. Exploration of the CBD was performed to extract gallstones. The CBD was drained with a T-tube. After 10 days, a T-tube cholangiogram reveals a retained CBD stone. This should be treated by which of the following?
If a stone is detected, the T tube should be left in place for 6 weeks to allow the tract to mature. At this time, the T tube can be removed, and the stone can be extracted by using a Dormia basket under fluoroscopy. This approach is indicated only when a T-tube larger than 16 has been inserted. If this approach is not feasible, the stone can be extracted by retrograde endoscopic techniques or CBD exploration.
Laparotomy and CBD exploration
Subcutaneous heparinization
Antibiotic therapy for 6 months and then reevaluation
Extraction of the stone through the pathway created by the T-tube (after 6 weeks)
Pancreas