Choledocholithiasis Without Cholelithiasis: Should the Gallbladder Stay or Should It Go?

Mutha, Pritesh; Shah, Tilak; Heuman, Douglas M.; Zfass, Alvin M.; Schubert, Mitchell L.

doi:10.1007/s10620-015-4003-3

Cited by 3 publications

(4 citation statements)

References 12 publications

(11 reference statements)

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“…In our study, the proportion reached 68.1% without excluding 21.1% of patients with gallbladder removed, which is consistent with previous studies. [ 2 ] At present, for patients with choledocholithiasis and gallstones or cholecystitis, procedures are recommended for both disorders. [ 9 , 15 , 16 ] However, there is no consensus on the interval between CBD and gallbladder surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Gallstones are an extremely common disease, and 5% to 21% of these patients have choledocholithiasis. [ 1 , 2 ] However, its incidence is extremely high in patients with choledocholithiasis, reaching 95%. [ 2 ] We know that most common bile duct (CBD) stones are secondary, which come from the intrahepatic bile duct and gallbladder, while primary CBD stones are rare.…”

Section: Introductionmentioning

confidence: 99%

“…[ 1 , 2 ] However, its incidence is extremely high in patients with choledocholithiasis, reaching 95%. [ 2 ] We know that most common bile duct (CBD) stones are secondary, which come from the intrahepatic bile duct and gallbladder, while primary CBD stones are rare. For those patients with choledocholithiasis and gallstones who only deal with choledocholithiasis, the recurrence rate of choledocholithiasis after surgery is 11% to 47%.…”

Section: Introductionmentioning

confidence: 99%

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A retrospective cohort study on the optimal interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy

et al. 2022

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Endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC) are the most important procedures for patients with choledocholithiasis and gallstones. Many studies recommend early LC after ERCP; however, there is still no consensus on the optimal interval between the two. The purpose of this study was to investigate the appropriate timing of LC after ERCP in patients with choledocholithiasis and cholecystolithiasis.We retrospectively reviewed all ERCPs in our institution from November 2014 to August 2021. All eligible 261 patients were divided into ERCP-LC1 (≤3 days), ERCP-LC2 (3-7 days), and ERCP-LC3 (>7 days). We also reviewed 90 patients with elective LC as the LC group. Procedures, treatment outcomes, and postoperative adverse events were evaluated.In a total of 1642 ERCPs, 261 eligible patients were divided into ERCP-LC1 (n = 102), ERCP-LC2 (n = 113), and ERCP-LC3 (n = 46). The ERCP-LC groups had no difference in operation time, postoperative adverse events, and open conversion rate with the LC group, but the total hospital stay and hospital stay after LC were longer than the LC group. There were no differences between the ERCP-LC groups in operation time, hospital stay after LC, open conversion rate, postoperative adverse events, and efficacy. However, LC within 7 days and even 3 days after ERCP had significant advantages in improvement in total length of stay and medical expenses. Furthermore, we also found an increased risk of gallbladder gangrene and perforation in LC >7 days after ERCP.LC within 7 days and even 3 days after ERCP is a safe, effective, and economical method for patients with choledocholithiasis and gallstones.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A retrospective cohort study on the optimal interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy

et al. 2022

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“…Because the presence of gallstones is a risk factor for recurrent biliary complications, subsequent cholecystectomy is approved as accepted management to prevent delayed biliary complications in patients with residual gallstones after endoscopic removal of BDS with EST [17, 18]. Two randomized studies reported that subsequent cholecystectomy reduced recurrent biliary events and should be recommended [19, 20].…”

Section: Discussionmentioning

confidence: 99%

Bile Duct Stones Predict a Requirement for Cholecystectomy in Older Patients

et al. 2019

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Background The requirement for elective cholecystectomy in older patients is unclear. To determine predictors for requiring elective cholecystectomy in older patients, a prospective cohort study was performed. Methods All patients with gallstone disease who presented to our department from 2006 to 2018 were included if they met the following criteria: (1) age 75 years or older, (2) presentation for elective cholecystectomy, and (3) preoperative diagnosis of cholecystolithiasis. Two therapeutic options, elective surgery and a wait-and-see approach, were offered at their initial visit. Enrolled patients were assigned to one arm of the study according to their choice of the therapeutic options. The primary endpoint was the incidence of gallstone-related complications. The endpoint was compared between patients who underwent cholecystectomy (CH group) and those who chose a wait-and-see approach (No-CH group). Results During the study period, there were 344 patients in the CH group and 161 in the No-CH group. Among patients with a history of bile duct stones, the incidence of gallstone-related complications in the No-CH group was significantly higher (45% within 3 years, including two gallstone-related deaths) than that in the CH group (RR 2.66, 95% confidence interval 1.50-4.77, p = 0.0009). Among patients with no history of bile duct stones, the incidence of gallstone-related complications in the No-CH group reached only 10% over the 12 years. Conclusion Cholecystectomy is recommended for older patients with both histories of cholecystolithiasis and bile duct stones, whereas a wait-and-see approach is preferable for patients with no bile duct stone history. A history of bile duct stones is a good predictor for cholecystectomy in older patients.

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Choledocholithiasis without cholecystolithiasis, after endoscopic retrograde cholangiopancreatography follow-up without cholecystectomy

Muhammedoğlu¹,

Pircanoğlu

Torun

2021

Konuralp Tıp Dergisi

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The widespread use of imaging methods increases the diagnosis and incidence of cholelithiasis. In recent years, management of patients with cholelithiasis has improved significantly owing to significant advances in surgical and endoscopic intervention. Methods: Between February 2015 and January 2018, the data of patients who underwent ERCP at our institution were collected prospectively and analyzed retrospectively. Forty-four patients included in the study were patients with choledocholithiasis without stones in the GB. Results: The mean age of 52 subjects (group A) included in the study was 64.83 ± 17.06, of which 23 (44.2%) were <65 years old and 29 (55.8%) were ≥65 years old. Twenty-four (46.2%) women and twenty-eight (53.8%) men were included in the study. Malignancy was suspected in 6 (11.5%) patients and no suspicion of malignancy was confirmed after Endoscopic Retrograde Cholangio-Pancreatography (ERCP) procedure. In group A, 14 patients (26.9%) required a second ERCP, while in group B, the number of patients requiring a second ERCP was 163 (21.3%). The mean length of hospital stay in group A and group B patients was 5.

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Choledocholithiasis Without Cholelithiasis: Should the Gallbladder Stay or Should It Go?

Cited by 3 publications

References 12 publications

A retrospective cohort study on the optimal interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy

A retrospective cohort study on the optimal interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy

Bile Duct Stones Predict a Requirement for Cholecystectomy in Older Patients

Choledocholithiasis without cholecystolithiasis, after endoscopic retrograde cholangiopancreatography follow-up without cholecystectomy

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