Efficacy and Safety of Early Laparoscopic Common Bile Duct Exploration as Primary Procedure in Acute Cholangitis Caused by Common Bile Duct Stones

Gholipour, Changiz; Shalchi, Rosita Alizadeh; Abbasi, Moslem

doi:10.1089/lap.2006.0199

Cited by 25 publications

(17 citation statements)

References 17 publications

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“…In addition, single-stage management also eliminates the underlying risk of ERCP/endoscopic sphincterotomy and keeps the sphincter of Oddi intact. Furthermore, previous studies have also demonstrated the feasibility and safety of LCBDE in the urgent setting [28,29]. Therefore, as laparoscopic expertise and operators' experience improve, single-stage LCBDE plus LC management would be ultimately available for most patients, including emergency patients.…”

Section: Discussionmentioning

confidence: 99%

Primary Closure and Rate of Bile Leak following Laparoscopic Common Bile Duct Exploration via Choledochotomy

et al. 2015

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Background: Choledocholithiasis is traditionally managed by endoscopic retrograde cholangiopancreatography or T-tube insertion following common bile duct exploration. This study examined the efficacy and safety of primary duct closure following laparoscopic common bile duct exploration (LCBDE) via choledochotomy. Methods: Between September 2011 and September 2013, 157 consecutive patients underwent LCBDE via choledochotomy. Results: Of 157 LCBDE procedures, 138 (87.9%) were successfully completed with primary closure of the choledochotomy. Eight patients (5.1%) underwent closure with T-tube drainage after choledochotomy and 11 patients (7.0%) were converted to open surgery. The biliary tree was free of stones at the end of surgery in 154 patients (98.1%). Postoperative bile leak occurred in 6 patients (3.8%). The median follow-up period was 18 (2-33) months, with no evidence of further bile duct stones or bile duct stricture in any patients. Univariable analysis revealed that successful duct clearance (p = 0.010) and diameter of the common bile duct (p < 0.001) were two significant risk factors for bile leak. Conclusions: Primary duct closure following LCBDE is effective and safe for the management of choledocholithiasis. The postoperative bile leak rate may be low in skilled laparoscopic surgeons with a careful selection of patients.

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Section: Discussionmentioning

confidence: 99%

Primary Closure and Rate of Bile Leak following Laparoscopic Common Bile Duct Exploration via Choledochotomy

et al. 2015

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“…Several randomized controlled trials showed similar effectiveness for both methods of treatment [38,39]. Patients treated with LCBDE had a significantly shorter hospital stay and lower hospital costs as compared with ERCP/EST [40,41,42]. …”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Exploration versus Intraoperative Endoscopic Sphincterotomy for Common Bile Duct Stones: A Prospective Randomized Trial

Elgeidie¹,

Elshobary²,

Naeem³

2011

Dig Surg

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Background/Aims: Laparoscopic cholecystectomy (LC) combined with intraoperative endoscopic sphincterotomy (IOES) was compared to LC with laparoscopic common bile duct exploration (LCBDE) to define the best single-session minimally invasive treatment for cholecystocholedocholithiasis. Methods: Between June 2009 and December 2010, patients with gallstones and common bile duct (CBD) stones diagnosed by preoperative ultrasonography and magnetic resonance cholangiopancreatography were randomized to LC-LCBDE or LC-IOES. The primary end point was complete clearance of CBD of stones. The secondary end points were operation time, conversion rate, length of hospital stay, complications and mortality. Results: Two hundred and twenty-six patients were eligible. They were randomized to LC-LCBDE (n = 115) and LC-IOES (n = 111). There was no statistically significant difference in the success rate of CBD clearance between the two interventions (92% for LC-LCBDE vs. 97.2% for LC-IOES with a p value >0.05). There were no differences between the two groups in terms of surgical time and postoperative length of stay. Pancreatitis and bleeding sphincterotomy were significantly more prevalent in the LC-IOES group, while bile leakage and retained CBD stones were significantly more prevalent in the LC-LCBDE group. Conclusion: Both LC-IOES and LC-LCBDE were shown to be safe, effective, minimally invasive treatments for cholecystocholedocholithiasis, but the former option may be preferred when facilities and experience in endoscopic therapy exist.

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“…Successful laparoscopic access to the biliary tract, through the cystic duct or by choledochotomy, has been reported to be safe, efficient, and cost-effective [9][10][11][12][13][14][15]. Laparoscopic common bile duct exploration (LCBDE) was associated with successful stone clearance rates ranging from 85-95%, a morbidity rate of 4-16%, and a mortality rate of approximately 0-2% [10,11,[25][26][27][28]. However, the efficacy of this approach, particularly for treatment of large or impacted ductal stones, needs more evaluation.…”

Section: Discussionmentioning

confidence: 99%

Preoperative versus intraoperative endoscopic sphincterotomy for management of common bile duct stones

Elgeidie¹,

Ebidy²,

Naeem³

2010

Surg Endosc

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Efficacy and Safety of Early Laparoscopic Common Bile Duct Exploration as Primary Procedure in Acute Cholangitis Caused by Common Bile Duct Stones

Abstract: Early one-stage LCBDE is an effective procedure as an initial and definite management of acute gallstone cholangitis, which prevents a second hospitalization and relapse problems.

Cited by 25 publications

References 17 publications

Primary Closure and Rate of Bile Leak following Laparoscopic Common Bile Duct Exploration via Choledochotomy

Primary Closure and Rate of Bile Leak following Laparoscopic Common Bile Duct Exploration via Choledochotomy

Laparoscopic Exploration versus Intraoperative Endoscopic Sphincterotomy for Common Bile Duct Stones: A Prospective Randomized Trial

Preoperative versus intraoperative endoscopic sphincterotomy for management of common bile duct stones

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