Comparative Study of Three Bile Duct Closure Methods Following Laparoscopic Common Bile Duct Exploration for Choledocholithiasis

Parra-Membríves, Pablo; Martínez-Baena, Darío; Lorente-Herce, José Manuel; Jiménez-Riera, Granada

doi:10.1089/lap.2017.0433

Cited by 29 publications

(37 citation statements)

References 34 publications

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“…In 16 studies, 9,12,21,23,26,28,30,33,34,37–41,43,44 46 patients (4.6%) in the PDC group and 59 patients (7.1%) in the TTD group had bile leak. The result tended to favor the PDC group, which showed a lower incidence of bile leak; however, no significant difference was found (OR = 0.68, 95% CI = 0.45–1.03, P = .07; no heterogeneity was found; I 2 = 0%; P = .99) ( Figure 2A ).…”

Section: Resultsmentioning

confidence: 99%

“…Seven were randomized controlled trials, 9,21,23,24,38,42,43 and the other 19 were retrospective cohort studies or prospective cohort studies. Sixteen studies 9,12,21,23,26,28,30,33,34,37–41,43,44 compared LCBDE+PDC with LCBDE+TTD. Eight studies 24,25,28,29,32,36,42,45 compared LCBDE+PDC+IBD with LCBDE+TTD; three studies 27,31,35 compared LCBDE+ PDC+EBD with LCBDE+TTD; and one study 28 compared three bile duct closure methods following LCBDE ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…In the 16 studies 9,12,21,23,26,28,30,33,34,37–41,43,44 that compared LCBDE+PDC with LCBDE+TTD, 74 patients (7.5%) in the PDC group and 106 patients (12.8%) in the TTD group developed postoperative complications; the PDC group showed a significantly lower overall morbidity than did the TTD group (OR = 0.55, 95% CI = 0.39–0.76, P = .0004; no heterogeneity was found; I 2 = 0%; P = .91) ( Figure 1A ). Thirty-three of the 106 patients developed postoperative complications due to T-tube removal or accidental dislodgement in the TTD group 9,12,21,23,26,28,30,33,34,38,39,43 ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…In the 11 studies 24,25,27–29,31,32,35,36,42,45 included in the subgroup analysis, 45 patients (11.3%) in the LCBDE+PDC+BD group and 71 patients (18.2%) in the LCBDE+TTD group developed postoperative complications; the PDC+BD group showed a significantly lower overall morbidity than did the TTD group (OR = 0.58, 95% CI = 0.38–0.89, P = .01; the heterogeneity could be accepted; I 2 = 31%; P = .15) ( Figure 1B ). Twenty-six patients 27–29,32,36,45 in the TTD group developed complications associated with T tube use ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

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T-Tube Use After Laparoscopic Common Bile Duct Exploration

Jiang

Zhao

Cheng

2019

JSLS

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Background and Objectives:Laparoscopic common bile duct exploration (LCBDE) has been verified to be an effective technique in treating choledocholithiasis, and T-tube insertion has been widely performed after LCBDE. With growing doubts regarding the effectiveness and safety of T-tube drainage (TTD), it has been suggested to replace such with primary duct closure (PDC). This meta-analysis aimed to evaluate the short- and long-term effectiveness and safety of PDC compared with TTD after LCBDE.Methods:The PubMed, Science Citation Index, and Cochrane Central Register of Controlled Trials databases were used to accomplish a systematic literature search for randomized controlled trials and pro-/retrospective cohort studies that compared PDC alone or PDC combined with biliary drainage stenting (PDC+BD) with TTD after LCBDE. A subgroup analysis was established to compare PDC+BD with TTD. RevMan 5.3 was used for the statistical analysis.Results:A total of 2552 patients from 26 studies were included. The pooled odds ratio supported PDC, which yielded lower postoperative overall morbidity and incidence of bile leak and bile peritonitis and shorter surgical time and postoperative hospital stay when compared with TTD. In the subgroup analysis, PDC+BD showed significantly better results in terms of postoperative overall morbidity, incidence of bile leak and bile peritonitis, surgical time, and postoperative hospital stay than did TTD. PDC and PDC+BD showed no difference in the incidence of recurrent stones and biliary stricture during the long-term follow-up period compared with TTD.Conclusion:PDC alone or PDC+BD is superior to TTD as a duct-closure method after LCBDE.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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T-Tube Use After Laparoscopic Common Bile Duct Exploration

Jiang

Zhao

Cheng

2019

JSLS

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“…More recent trends towards primary closure without a T‐tube are often limited by the diameter of the bile duct as a risk factor for the leak. The leak, however, is usually of little clinical importance compared with the added morbidity associated with T‐tube or stent insertion.…”

Section: Discussionmentioning

confidence: 99%

Meta‐analysis of laparoscopic transcysticversustranscholedochal common bile duct exploration for choledocholithiasis

et al. 2019

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Background It is not clear whether laparoscopic transcystic exploration (LTCE) laparoscopic choledochotomy (LCD) is superior in the management of choledocholithiasis. In this meta‐analysis, the success of LTCE versus LCD was evaluated. Methods Cochrane Central Register of Controlled Trials, Web of Science, Trip, PubMed, Ovid and Embase databases were searched systematically for relevant literature up to May 2017. Studies that compared the success rate of LTCE and LCD in patients with choledocholithiasis were included. PRISMA guidelines were followed. Multiple independent reviewers contributed on a cloud‐based platform. Random‐effects model was used to calculate odds ratios (ORs) or standardized mean differences (MDs) with 95 per cent confidence intervals. An a priori hypothesis was generated based on clinical experience that LTCE is as successful as LCD. Results Of 3533 screened articles, 25 studies comprising 4224 patients were included. LTCE achieved a lower duct clearance rate than LCD (OR 0.38, 95 per cent c.i. 0·24 to 0·59). It was associated with a shorter duration of surgery (MD −0·86, 95 per cent c.i. −0·97 to −0·77), lower bile leak (OR 0·46, 0·23 to 0·93) and shorter hospital stay (MD −0·78, −1·14 to −0·42) than LCD. There was no statistically significant difference in conversion, stricture formation or reintervention rate. Conclusion LCD has a higher rate of successful duct clearance, but is associated with a longer duration of surgery and hospital stay, and a higher bile leak rate.

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Risk factors for biliary tract events during elective cholecystectomy waiting time after endoscopic retrograde cholangiopancreatography for choledocholithiasis

Satoh,

Kaneko,

Kawaguchi

et al. 2024

DEN Open

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ObjectivesEndoscopic lithotripsy and elective cholecystectomy, followed by endoscopic retrograde cholangiopancreatography, are the first‐line treatments for patients with common bile duct (CBD) stones (CBDS) and gallstones. However, this approach entails acute cholecystitis and recurrent cholangitis risk while patients await surgery. We aimed to identify acute cholecystitis and cholangitis risk factors during the waiting time for elective cholecystectomy.MethodsThis study comprised 151 patients with CBDS combined with gallstones who underwent cholecystectomy within 90 days of the first endoscopic retrograde cholangiopancreatography at two tertiary care centers between January 2019 and October 2021.ResultsThe incidence of biliary tract events (acute cholecystitis, acute cholangitis, or any complications requiring unplanned cholangiopancreatography) was 28% (43 cases). In univariate and multivariate analyses, plastic stent placement as a bridge to surgery for the first treatment of CBDS was an independent risk factor for biliary tract events during the waiting time for surgery (odds ratio 4.25, p = 0.002). A subgroup analysis among those with plastic stent placement revealed a CBD diameter of ≤ 10 mm as an independent risk factor for acute cholecystitis (odds ratio 4.32; p = 0.027); a CBD diameter ≥ 11 mm was an independent risk factor for acute cholangitis and unplanned re‐endoscopic retrograde cholangiopancreatography (odds ratio 5.66; p = 0.01).ConclusionsPlastic stent placement for CBDS before elective cholecystectomy increases the risk of acute cholecystitis or acute cholangitis during the waiting time for elective cholecystectomy.

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Comparative Study of Three Bile Duct Closure Methods Following Laparoscopic Common Bile Duct Exploration for Choledocholithiasis

Cited by 29 publications

References 34 publications

T-Tube Use After Laparoscopic Common Bile Duct Exploration

T-Tube Use After Laparoscopic Common Bile Duct Exploration

Meta‐analysis of laparoscopic transcysticversustranscholedochal common bile duct exploration for choledocholithiasis

Risk factors for biliary tract events during elective cholecystectomy waiting time after endoscopic retrograde cholangiopancreatography for choledocholithiasis

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