Laparoscopic choledochoduodenostomy as a reliable rescue procedure for complicated bile duct stones

Senthilnathan, Palanisamy; Sharma, Dheeraj; Sabnis, Sandeep C; Gurumurthy, S. Srivatsan; Anand, E. Senthil; Nalankilli, V.P.; Vijai, N. Anand; Raj, Palanivelu Praveen; Parthasarathy, R.; Rajapandian, Subbiah; Palanivelu, Chinnusamy

doi:10.1007/s00464-017-5868-3

Cited by 18 publications

(17 citation statements)

References 29 publications

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“…‘End‐to‐side’ may be a better method to reduce regurgitation and biliary infection. Senthilnathan et al 65 . advocated laparoscopic CDS as a reliable rescue procedure for complicated CBD stones.…”

Section: Resultsmentioning

confidence: 99%

Risk factors and management of primary choledocholithiasis: a systematic review

Zhang

Ling

2020

ANZ Journal of Surgery

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Background Primary choledocholithiasis (PC) is a common disease in biliary surgery. The treatment is always challenging due to its high recurrence. A systemic review is undertaken to determine the risk factors for recurrence and provide with the individualized management strategy. Methods Electronic databases PubMed (Medline), Embase and Cochrane Central Register of Controlled Studies were searched for relevant articles on risk factors for PC recurrence. Its therapeutic intervention was also collected and analysed. Results A total of 36 articles were eligible for inclusion. The recurrent risk factors include abnormalities of biliary anatomy (peripapillary diverticulum), dynamics (choledochal dilation, sharp angulation and stone number), metabolism (advanced age and hypothyroidism) and bacterial infection (Enterobacter and Helicobacter pylori). These factors eventually induce cholestasis and stone formation. At present, there is no guideline and expertise consensus for PC management. The treatment mainly consists of stone retrieval approaches and internal drainage surgeries. The former are minimally invasive methods: endoscopic sphincterotomy (EST), papillary balloon dilation (EPBD) and laparoscopic common bile duct exploration (LCBDE). The latter include choledochoduodenostomy (CDS) and choledochojejunostomy (CJS) with Roux‐en‐Y reconstruction. By far, the internal drainage surgeries have significantly lower recurrence than stone retrieval approaches. Conclusion Abnormal biliary anatomy, dynamics, metabolism and bacterial infection are the risk factors for PC. Both EST/EPBD and LCBDE can be performed as initial treatment. For recurrent PC, CDS is more suitable to the elderly, while Roux‐en‐Y CJS reserves for young patients or those in good conditions.

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Section: Resultsmentioning

confidence: 99%

Risk factors and management of primary choledocholithiasis: a systematic review

Zhang

Ling

2020

ANZ Journal of Surgery

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“…1 At present, laparoscopic biliary exploration and biliary plasty is becoming a relatively safe, reliable, and effective method, which can be attempted in the cases with mild intraabdominal adhesions or bile duct stenosis. 63 Compared with traditional laparoscopic surgery, robotic laparoscopic surgery has more advantages in terms of surgical vision, surgical instruments, and flexibility of surgical operations. The fine anatomic separation can help high-quality minimally invasive surgery in the treatment of hilar bile duct disease.…”

Section: Laparoscopic Surgery For Complicated Hepatolithiasismentioning

confidence: 99%

Application of Laparoscopic Technique in the Treatment of Hepatolithiasis

Yao¹,

Wu²

2020

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Hepatolithiasis is commonly encountered in Southeastern and East Asian countries, and its incidence is increasing in Western countries. For symptomatic hepatolithiasis or asymptomatic hepatolithiasis with signs of liver atrophy or malignancy, surgical intervention is needed, especially when peroral cholangioscopy and percutaneous transhepatic cholangioscopic lithotomy are not suitable or fail to be performed. Currently, laparoscopic surgery is gradually replacing traditional open surgery and becoming a better option. Various types of laparoscopic surgeries, including laparoscopic hepatectomy, laparoscopic biliary exploration through the common bile duct or the hepatic duct stump, and robotic-assisted laparoscopic surgery, have been developed for the treatment of simple hepatolithiasis, hepatolithiasis concomitant with choledocholithiasis, recurrent hepatolithiasis, and complicated hepatolithiasis. The related clinical experience is gradually accumulating. In this review, the laparoscopic applications and their advantages will be summarized. In most cases, the laparoscopic technique could provide the advantages of less trauma, reduced blood loss, and faster postoperative recovery.

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“…Así, la exploración de la vía biliar y la realización de la coledocoduodenostomía laparoscópica, efectuada por grupos experimentados, ha demostrado ser eficaz y segura en el tratamiento de casos complejos de coledocolitiasis (coledocolitiasis múltiple, cálculos impactados, cálculos en conductos hepáticos, estenosis biliares y coledocolitiasis recidivante) o en escenarios de una CPRE fallida. Esta técnica quirúrgica ha demostrado, además, una corta estancia hospitalaria (20).…”

Section: Discussionunclassified

Tratamiento de la coledocolitiasis mediante CPRE e instrumentación a través de un tubo en T

Ortíz

Duarte-Osorio

García-Echeverri

et al. 2020

Rev Colomb Gastroenterol

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El tratamiento de la coledocolitiasis ha evolucionado de forma significativa desde que Robert Abbe realizó la primera coledocotomía y la exploración de las vías biliares en Nueva York, en 1889. La colangiopancreatografía retrógrada endoscópica (CPRE), que inicialmente fue un método diagnóstico, ahora solo tiene validez como método terapéutico. En la actualidad, los principales métodos diagnósticos son la colangioresonancia magnética (CRM) y la ultrasonografía endoscópica (USE). El tratamiento de la coledocolitiasis pasó de la técnica quirúrgica abierta -en la que, de forma rutinaria, se realizaba la coledocorrafia sobre un tubo de Kehr o tubo en T- a la endoscópica, mediante el uso de la CPRE, la esfinteroplastia y la instrumentación con balones y canastilla. Hoy en día se dispone de técnicas adicionales como la litotricia mecánica (LM) o extracorpórea, la dilatación con balón (DB) de gran tamaño y el Spyglass®. La técnica laparoscópica se usa desde hace varios años, en diversas partes del mundo, para el tratamiento de la coledocolitiasis. Estudios recientes proponen incluso el cierre primario del colédoco o la coledocoduodenostomía, con lo cual no sería necesaria la utilización del tubo en T. Pero en muchos otros sitios, y por diversas razones, se continúa usando la exploración quirúrgica abierta y el tubo en T, que representa una importante opción en el tratamiento de algunos pacientes. Caso clínico: paciente masculino de 88 años, con coledocolitiasis recidivante, cálculo gigante de difícil manejo endoscópico y sepsis de origen biliar, que requirió drenaje quirúrgico abierto de urgencias. Se realizó una coledocotomía, y se dejó el tubo en T. Posteriormente, se efectuó un tratamiento exitoso conjunto, mediante instrumentación por el tubo en T, por parte de cirugía general, y CPRE, por gastroenterología.

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Laparoscopic choledochoduodenostomy as a reliable rescue procedure for complicated bile duct stones

Abstract: Laparoscopic common bile duct exploration with choledochoduodenostomy has been shown to be a safe, reliable, and efficient method for treating complex CBDS, especially after failed ERCP procedures.

Cited by 18 publications

References 29 publications

Risk factors and management of primary choledocholithiasis: a systematic review

Risk factors and management of primary choledocholithiasis: a systematic review

Application of Laparoscopic Technique in the Treatment of Hepatolithiasis

Tratamiento de la coledocolitiasis mediante CPRE e instrumentación a través de un tubo en T

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