Intraoperative ERCP: What role does it have in the era of laparoscopic cholecystectomy?

Rábago, Luís

doi:10.4253/wjge.v3.i12.248

Cited by 18 publications

(14 citation statements)

References 54 publications

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“…LCBDE has shown that it has a high success rate and is just as efficient and safe as preoperative or postoperative ERCP [2,10,11]. Currently, LCBDE is considered the most desirable minimally invasive option for treatment of patients with CCL, and open laparotomy to be done only when laparoscopic management is not possible.…”

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confidence: 99%

Intraoperative ERCP for management of cholecystocholedocholithiasis

2016

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Intraoperative ERCP for management of cholecystocholedocholithiasis

2016

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“…Una duración media de 35 minutos para la CPRE+EE intraoperatoria y duración media de la cirugía de 104 minutos, con rangos de 75-200 minutos (EL NAKEEB, A. et al, 2015). La tasa media de conversión a cirugía abierta 4,7 %, morbilidad del 5,1 % (0 % -19 %) y una mortalidad extremadamente rara 0,37 % (RÁBAGO et al, 2011). Benci hace mención a complicaciones como el sangrado por la realización de esfinterotomía: 1.6 %-6 % y pancreatitis: 1.7 %-7 % (BENCINI et al, 2014;YOUNG-HAN J., et al 2015).…”

Section: Discussionunclassified

Evaluación costo efectividad del tratamiento en un solo tiempo de colelitiasis con coledocolitiasis mediante el uso de laparoscopia y su asociación con el abordaje laparo-endoscópico

Orquera

Páez

2018

prosciences

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Evaluación costo efectividad del tratamiento en un solo tiempo de colelitiasis con coledocolitiasis mediante el uso de laparoscopia y su asociación con el abordaje laparo-endoscópico Resumen: El tratamiento de colelitiasis con coledocolitiasis (CBD) en tiempoúnico es efectivo, más la relación costo efectividad del acceso exclusivo por laparoscopia es aún motivo de investigación siendo este nuestro objetivo. Métodos: análisis retrospectivo, transversal de pacientes operados laparoscópicamente por colelitiasis y coledocolitiasis en servicios públicos de salud, distribuidos en dos grupos: Grupo L (exploración laparoscópica de la vía biliar, Hospital Pablo Arturo Suárez -Quito (H.PAS). Grupo LE (exploración laparo endoscópica, Hospital de Clínicas de la Facultad de Medicina de Ribeirão Preto -Universidad de Sao Paulo (USP HCFMRP) período de junio 2016-junio 2017. Resultados: Los grupos fueron homogéneos para la mayoría de las variables epidemiológicas y clínicas antes de los procedimientos quirúrgicos, la efectividad del tratamiento quirúrgico valorado como aclaramiento del colédoco fue 100 % , la tasa de complicaciones precoces fueron equivalentes en los dos grupos (16,6 %); el tiempo quirúrgico en el G L fue 168,36 minutos (58,36 minutos DP), y en el G LE de 117,06 minutos (29,43 DP), p= 0,001; el período de internación fue 2,2 días (1,83 DP) en el Grupo I-L y para el Grupo LE 1. 1 días (1,83 DP) p= 0,01. La selección de casos en el GLE benefició a 14 pacientes tratados ambulatoriamente, con una efectividad de 100 % y un costo medio de atención hospitalaria de $1179,81 (DP $200,60), en comparación con los pacientes que requirieron hospitalización $ 1509,19 (DP $ 426,04) generando una diferencia de costos estadística significativa p=0,039. Concluimos que el tratamiento quirúrgico laparoendoscópico es costo efectivo.Palabras Clave-Coledocolitiasis. Laparoscopia. Esfinterotomía Endoscópica intraoperatoria. Análisis de costo efectividad.

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“…Published data evidence that associated endoscopic-laparoscopic approach necessitates increased number of procedures per patient while LCBDE is associated with a shorter hospital stay [15][16][17] . Moreover, the long-term sequelae of sphincterotomy can also be avoided with laparoscopic bile duct clearance [18,19] .…”

Section: Analysis Of the Current Literaturementioning

confidence: 99%

Minimally invasive treatment of cholecysto-choledocal lithiasis: The point of view of the surgical endoscopist

Palma

2013

WJGS

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The rate of choledocholithiasis in patients with symptomatic cholelithiasis is estimated to be approximately 10%-33%, depending on the patient's age. Development of Endoscopic Retrograde Cholangiopancreatography and Laparoscopic Surgery and improvement of diagnostic procedures have influenced new approaches to the management of common bile duct stones in association with gallstones. At present available minimally-invasive treatments of cholecysto-choledocal lithiasis include: single-stage laparoscopic treatment, perioperative endoscopic treatment and endoscopic treatment alone. Published data evidence that, associated endoscopic-laparoscopic approach necessitates increased number of procedures per patient while single-stage laparoscopic treatment is associated with a shorter hospital stay. However, current data does not suggest clear superiority of any one approach with regard to success, mortality, morbidity and cost-effectiveness. Considering the variety of therapeutic options available for management, a critical appraisal and decision-making is required. Endoscopic retrograde cholangiopancreatography/EST should be adopted on a selective basis, i.e. , in patients with acute obstructive suppurative cholangitis, severe biliary pancreatitis, ampullary stone impaction or severe comorbidity. In a setting where all facilities are available, decision in the selection of the therapeutic option depends on the patients, the number and size of choledocholithiasis stones, the anatomy of the cystic duct and common bile duct, the surgical history of patients and local expertise. At present available minimally-invasive treatments include: single-stage laparoscopic treatment, perioperative endoscopic treatment and endoscopic treatment alone. Current data does not suggest clear superiority of any one approach with regard to success, mortality, morbidity and costeffectiveness. Considering the variety of therapeutic options available for management, a critical appraisal and decision-making is required. This should preferably be dictate on the patient, the clinical presentation, the timing of diagnosis (established pre-operative diagnosis or incidental intraoperative diagnosis), the surgical pathology and the local expertise.De Palma GD. Minimally invasive treatment of cholecysto-choledocal lithiasis: The point of view of the surgical endoscopist.

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Intraoperative ERCP: What role does it have in the era of laparoscopic cholecystectomy?

Cited by 18 publications

References 54 publications

Intraoperative ERCP for management of cholecystocholedocholithiasis

Intraoperative ERCP for management of cholecystocholedocholithiasis

Evaluación costo efectividad del tratamiento en un solo tiempo de colelitiasis con coledocolitiasis mediante el uso de laparoscopia y su asociación con el abordaje laparo-endoscópico

Minimally invasive treatment of cholecysto-choledocal lithiasis: The point of view of the surgical endoscopist

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