Balloon sphincteroplasty in pediatric laparoscopic common bile duct exploration

Bosley, Maggie E.; Gaffley, Michaela; Zeller, Kristen A.; Sieren, Leah M.; Petty, John K.; Pranikoff, Thomas; Neff, Lucas P.

doi:10.1016/j.jpedsurg.2020.12.001

Cited by 13 publications

(7 citation statements)

References 14 publications

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“…There were no intraoperative or postoperative complications, including postprocedural pancreatitis. This data is consistent with the additional 15 pediatric patients who have undergone balloon sphincteroplasty at the same institution with a 100% clearance rate and no reported complications 17 …”

Section: Patient Experience and Outcomessupporting

confidence: 85%

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Antegrade balloon sphincteroplasty as an adjunct to laparoscopic common bile duct exploration for the acute care surgeon

Bosley

Nunn²,

Westcott³

et al. 2021

J Trauma Acute Care Surg

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Section: Patient Experience and Outcomessupporting

confidence: 85%

“…This data is consistent with the additional 15 pediatric patients who have undergone balloon sphincteroplasty at the same institution with a 100% clearance rate and no reported complications. 17…”

Section: Patient Experience and Outcomesmentioning

confidence: 99%

Antegrade balloon sphincteroplasty as an adjunct to laparoscopic common bile duct exploration for the acute care surgeon

Bosley

Nunn²,

Westcott³

et al. 2021

J Trauma Acute Care Surg

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“…Antegrade balloon sphincteroplasty is then performed at the ampulla of Vater to facilitate common bile duct clearance. 17 18 Clearance was confirmed with use of IOC. If failure of LC+LCBDE to clear the common bile duct occurred, the LC was completed and patients were referred for postoperative ERCP.…”

Section: Methodsmentioning

confidence: 84%

“…A transcystic catheter-based approach, as has previously been described by this group, was employed. 17 18 In brief, after confirmation of common bile duct stone via intraoperative cholangiography (IOC), a cystic duct ductotomy is made and a 0.035″ floppy guidewire is inserted into the cystic duct, traversing the common bile duct, and ending in the duodenum. Antegrade balloon sphincteroplasty is then performed at the ampulla of Vater to facilitate common bile duct clearance.…”

Section: Methodsmentioning

confidence: 99%

Win or lose, nighttime transcystic laparoscopic common bile duct exploration is a win

Stettler

Ganapathy

Bosley

et al. 2023

Trauma Surg Acute Care Open

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ObjectivesAlthough controversial, recent data suggest nighttime versus daytime laparoscopic cholecystectomy (LC) have comparable outcomes. Laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis decreases length of stay (LOS) as compared with LC with endoscopic retrograde cholangiopancreatography (ERCP) but increases case complexity/time. The influence of time of day on LCBDE outcomes has not been evaluated. Our aim was to examine outcomes and LOS for nighttime (PM) compared with daytime LC+LCBDE (DAY).MethodsConsecutive patients who underwent LCBDE were reviewed. Demographics, operative duration, success of LCBDE, time to postoperative ERCP (if required), LOS, and complications were compared. PM procedures were defined as beginning 19:00–07:00 hours.ResultsBetween 2018 and 2022, sixty patients underwent LCBDE (PM 42%). Groups had equivalent age/sex and preoperative liver function tests (LFTs). LCBDE success was 69% PM versus 71% DAY (p=0.78). Operative duration did not differ (2.8 IQR: 2.2–3.3 hours vs. 2.8 IQR: 2.3–3.2 hours, p=0.9). LOS was compared, and PM LOS was shorter (p=0.03). Time to ERCP after a failed LCBDE at night was compared with daytime (13.8 IQR: 10.6–29.5 hours vs. 19.9 IQR: 18.7–54.4 hours, p=0.07). LOS forfailedPM LCBDE requiring ERCP was similar tosuccessfulDAY LCBDE (p=0.29). One complication (transient hyperbilirubinemia) was reported in the DAY group, none in PM.ConclusionPM LCBDE cases are equivalent in safety and success rate to DAY cases but have reduced LOS. Widespread adoption of acute care surgery-driven management of choledocholithiasis via LCBDE during cholecystectomy may decrease LOS, especially in PM cases.Level of evidenceLevel IV.

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“…Therefore the laparoscopic common bile duct exploration is a safe alternative to ERCP in the treatment of pediatric choledocholithiasis and is recommended to be a laparoscopic-first approach in the management of choledocholithiasis with IOC to avoid unnecessary procedures in these patients [ 4 ]. In an effort to minimize sedation and radiation exposure from fluoroscopy and to provide definitive treatment for choledocholithiasis during a single anesthetic event, some authors have employed dilating balloons via a trans-cystic approach to stretch the sphincter of Oddi with subsequent ductal flushing as a technique of balloon sphincteroplasty [ 5 ]. The choice between the trans-cystic duct approach or the choledochotomy approach should be tailored on the basis of information provided by routine intraoperative cholangiography (IOC) and the patient’s biliary tract anatomy.…”

Section: Discussionmentioning

confidence: 99%

Tips and Tricks—3 Use Cases of Interdisciplinary Knowledge Transfer in Minimally Invasive Pediatric Surgery

et al. 2022

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In the pediatric surgical environment, we can enrich our knowledge and improve our skills through interdisciplinary knowledge transfer in exchange with other surgical or even non-surgical disciplines. To demonstrate this, we present in this article three patient cases of method transfer enabling new techniques in minimally invasive pediatric surgery. 1. The somewhat modified application of the AeroStat rigid tip laparoscopic cholangiography catheter during the single-step laparoscopic cholecystectomy facilitates the safe intraoperative cholangiography with common bile duct flushing. 2. A magnetic rod is used during laparoscopic enterotomy to locate and retrieve ingested magnets. 3. Using a patient-specific MRI 3D model representing a syndromic high anorectal malformation improves surgical planning and parental education.

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Balloon sphincteroplasty in pediatric laparoscopic common bile duct exploration

Cited by 13 publications

References 14 publications

Antegrade balloon sphincteroplasty as an adjunct to laparoscopic common bile duct exploration for the acute care surgeon

Antegrade balloon sphincteroplasty as an adjunct to laparoscopic common bile duct exploration for the acute care surgeon

Win or lose, nighttime transcystic laparoscopic common bile duct exploration is a win

Tips and Tricks—3 Use Cases of Interdisciplinary Knowledge Transfer in Minimally Invasive Pediatric Surgery

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