Early postoperative endoscopic sphincterotomy for retained common bile duct stones

Danilewitz, Mervyn

doi:10.1016/s0016-5107(89)72795-4

Cited by 17 publications

(7 citation statements)

References 9 publications

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“…In the prelaparoscopic cholecystectomy era, the traditional management for CBD stones was to perform a choledochotomy and stone extraction. However, open CBD exploration is associated with significant morbidity and retained stone rate [5,18]. Preoperative ERCP and sphincterotomy were introduced to avoid the complications associated with open CBD exploration [11].…”

Section: Discussionmentioning

confidence: 99%

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Predictive factors for synchronous common bile duct stones in patients with cholelithiasis

et al. 1997

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Multivariate logistic regression analysis on these significant predictors showed that cholangitis (odds ratio [OR]: 10.5), dilated CBD with evidence of stones on ultrasound (OR: 7.4), elevated aspartate transaminase (OR: 2.9), and conjugated bilirubin (OR: 5.3) were jointly significant. The likelihood of having stones in the duct without any of these predictors was 7%, but 99% when all the predictors were positive.

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Section: Discussionmentioning

confidence: 99%

“…Endoscopic sphincterotomy (ES) was first introduced for removal of recurrent or retained stones after cholecystectomy [5]. However, its rapid success has expanded the indications.…”

mentioning

confidence: 99%

Predictive factors for synchronous common bile duct stones in patients with cholelithiasis

et al. 1997

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“…Bleeding is the main complication of precut papillotomy and may be related to the edema and congestion of the papilla [16]. Others reported similar low complication rates [8]. The slight signs or symptoms of cholestasis in two of our patients, observed at follow-up, are difficult to explain but were not necessarily caused by residual stone fragments.…”

Section: Discussionmentioning

confidence: 70%

Endoscopic management of retained bile stones with an indwelling T-tube

et al. 2004

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“…Classically, the surgery by laparotomy for access to the main biliary tract constituted the standard treatment for choledocholithiasis, preceding choledocholithotomy and external biliary drainage (80) . In the 70's, the introduction of the retrograde endoscopic cholangiography and subsequently papillotomy permitted a therapeutic alternative, especially in those patients that had previously been subject to cholecystectomy (12,17,23,44) . With the advent of videolaparoscopic surgery, the endoscopic approach became an important complementary procedure, recommended in the preoperative, when used for the diagnosis of choledocholithiasis, as well as in the postoperative period (9,32,34,46) .…”

Section: Introductionmentioning

confidence: 99%

Common bile duct stones: analysis of the videolaparoscopic surgical treatment

Santo

Domene

Riccioppo

et al. 2012

Arq. Gastroenterol.

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-Context -About 9% of the Brazilian population has gallstones and the incidence increases significantly with aging. The choledocholithiasis is found around 15% of these patients, and a third to half of these cases presented as asymptomatic. Once the lithiasis in the common bile duct is characterized through intraoperative cholangiography, the laparoscopic surgical exploration can be done through the transcystic way or directly through choledochotomy. Objective -To evaluate the results and outcomes of the laparoscopic treatment of common bile duct lithiasis. Methods -Seventy consecutive patients were evaluated. They prospectively underwent the treatment of the lithiasis in the common bile duct and the exploration ways were compared according to the following parameters: criteria on their indication, success in the clearance, surgical complications. It was verified that about ½ of the choledocholithiasis carriers did not show any expression of predictive factors (clinical antecedents of jaundice and/or acute pancreatitis, compatible sonographic data and the pertaining lab tests). The laparoscopic exploration through the transcystic way is favored when there are no criteria for the practice of primary choledochotomy, which are: lithiasis in the proximal bile duct, large (over 8 mm) or numerous calculi (multiple calculosis). Results -The transcystic way was employed in about 50% of the casuistic and the choledochotomy in about 30%. A high success rate (around 80%) was achieved in the clearance of the common bile duct stones through laparoscopic exploration. The transcystic way, performed without fluoroscopy or choledochoscopy, attained a low rate of success (around 45%), being 10% of those by transpapilar pushing of calculi less than 3 mm. The exploration through choledochotomy, either primary or secondary, if the latter was performed after the transcystic route failure, showed high success rate (around 95%). When the indication to choledochotomy was primary, the necessity for choledochoscopy through choledochotomy to help in the removal of the calculi was 55%. However, when choledochotomy was performed secondarily, in situations where the common bile duct diameter was larger than 6 mm, the use of choledochoscopy with the same purpose involved about 20% of the cases. There was no mortality in this series. Conclusion -The laparoscopic exploration of the common bile duct was related to a low rate of morbidity. Therefore, the use of laparoscopy for the treatment of the lithiasis in the common bile duct depends on the criteria for the choice of the best access, making it a safe procedure with very good results. HEADINGS -Choledocholithiasis. Laparoscopy. Cholangiography.

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Early postoperative endoscopic sphincterotomy for retained common bile duct stones

Cited by 17 publications

References 9 publications

Predictive factors for synchronous common bile duct stones in patients with cholelithiasis

Predictive factors for synchronous common bile duct stones in patients with cholelithiasis

Endoscopic management of retained bile stones with an indwelling T-tube

Common bile duct stones: analysis of the videolaparoscopic surgical treatment

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