Laparoscopic Common Bile Duct Exploration

Tinoco, Renam Catharina; Tinoco, Augusto; El-Kadre, Luciana; Peres, Leandro; Sueth, Daniela M.

doi:10.1097/sla.0b013e3181612c85

Cited by 77 publications

(58 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6 Most series continue to pool the results of transcystic and transductal approach es, and many have a relatively low proportion of LC. For example, Tinoco and colleagues 7 recently reported 481 laparoscopic CBD explorations, of which 69 were formal choledochotomy, and Riciardi and colleagues 12 reported 76 transductal procedures out of 346 explorations. 5,7,8,12 In the present study, postoperative adverse outcomes occurred in 23.9% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…For example, Tinoco and colleagues 7 recently reported 481 laparoscopic CBD explorations, of which 69 were formal choledochotomy, and Riciardi and colleagues 12 reported 76 transductal procedures out of 346 explorations. 5,7,8,12 In the present study, postoperative adverse outcomes occurred in 23.9% of patients. In this group, Clavien grade II-V complications occurred in 21.4% of patients, retained CBD stones were observed in 4%, and conversion to laparotomy occurred in 3.5%.…”

Section: Discussionmentioning

confidence: 99%

“…5,7,8 To the best of our knowledge, only 1 published study has specifically evaluated the predictors relating to poor outcomes after laparoscopic bile duct exploration. 8 However, in that report, they also pool the results of laparoscopic transductal, transcystic and radiological ex ploration.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Preoperative factors predicting poor outcomes following laparoscopic choledochotomy: a multivariate analysis study

Hong²,

Ni³

et al. 2013

cjs

View full text Add to dashboard Cite

Background: Laparoscopic surgery for common bile duct stones varies procedurally from a transcystic approach to laparoscopic choledochotomy (LC) with or without biliary drainage. However, LC is a difficult procedure with higher documented morbidity than the transcystic approach. We retrospectively investigated risk factors for adverse outcomes of LC. Methods:We used logistic regression models to assess 4 categories of adverse outcomes: overall, complications, conversion to open operation and failed surgical clearance. We calculated the area under the receiver operating characteristic curve to evalu ate diagnostic accuracy. Results:We included 201 patients who underwent LC in our analysis. Adverse outcomes occurred in 48 (23.9%) patients, complications occurred in 43 (21.4%), retained stones were observed in 8 (4%), and conversion to laparotomy occurred in 7 (3.5%). Multivariate analysis showed that total bilirubin (BIL) and the presence of medical risk factors (MRFs) were significant predictors of adverse outcomes and complications. We calculated the probability of adverse outcomes (p) using the following formula:According to their logit(p), all patients were divided into a low-risk group (logit(p) ≤ -1.32, n = 130) and a high-risk group (logit(p) > -1.32, n = 71). Patients in the low-risk group had about a 1 in 10 chance (12 of 130) of adverse outcomes developing. Of the 71 patients in the high-risk group, 36 (50.7%) experienced adverse outcomes. Conclusion:High BIL and the presence of MRFs could predict adverse outcomes in patients undergoing LC.Contexte : La chirurgie laparoscopique pour extraction de calculs biliaires logés dans le cholédoque diffère sur le plan technique de la cholédochotomie laparoscopique (CL) par approche transcystique avec ou sans drain biliaire. Toutefois, la CL est une intervention délicate, qui s'accompagne d'un taux de morbidité documenté plus élevé comparativement à l'extraction transcystique. Nous avons analysé rétrospectivement les facteurs de risque à l'égard d'une issue négative de la CL.Méthodes : Nous avons utilisé des modèles de régression logistique pour évaluer 4 catégories d'issue négative : issue négative globale, complications, conversion vers une chirurgie ouverte et échec de l'extraction chirurgicale. Nous avons calculé l'aire sous la courbe de la fonction d'efficacité du récepteur pour évaluer la précision diagnostique.Résultats : Nous avons inclus dans notre analyse 201 patients soumis à une CL. Une issue négative est survenue chez 48 patients (23,9 %), des complications chez 43 (21,4 %), la persistance des calculs chez 8 (4 %) et la conversion vers la laparotomie chez 7 (3,5 %). L'analyse multivariée a montré que la bilirubine totale ( Conclusion : Un taux de BIL élevé et la présence de FRM pourraient prédire l'issue négative chez des patients soumis à une CL.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Preoperative factors predicting poor outcomes following laparoscopic choledochotomy: a multivariate analysis study

Hong²,

Ni³

et al. 2013

cjs

View full text Add to dashboard Cite

show abstract

“…With the development of techniques and improvement of instruments, 4-port laparoscopic common bile duct exploration (LCBDE) has been used to treat choledocholithiasis for many years in clinical practice [1]- [4]. The purpose of this study was to investigate the feasibility, safety and the clinical value of primary suture following 3-port laparoscopic common bile duct exploration (LCBDE).…”

Section: Introductionmentioning

confidence: 99%

Clinical Application of Primary Suture Following Three-Port Laparoscopic Common Bile Duct Exploration: A Report of 176 Cases

Li¹,

Cai²,

Sun³

et al. 2015

View full text Add to dashboard Cite

“…In the literature, the ductal stone clearance rate for all comers is approximately 85% to 97.3% and has an associated mortality rate of 0.3% to 0.8% and morbidity of 3.7% to 33%. [9][10][11][12][13] The overall length of stay is shorter in LCBDE compared with the 2-stage approach.…”

mentioning

confidence: 99%

Common Bile Duct Exploration in an Elderly Asian Population

Shelat

Chia

Low

2015

International Surgery

View full text Add to dashboard Cite

Common bile duct exploration (CBDE) is an accepted treatment for choledocholithiasis. This procedure is not well studied in the elderly population. Here we evaluate the results of CBDE in elderly patients (.70 years) and compare the open (group A) with the laparoscopic group (group B). A retrospective review was performed of elderly patients with proven common bile duct (CBD) stones who underwent CBDE from January 2005 to December 2009. There were 55 patients in group A and 33 patients in group B. Mean age was 77.6 years (70-91 years). Both groups had similar demographics, liver function tests, and stone size-12 mm (range, 5-28 mm). Patients who had empyema (n ¼ 9), acute cholecystitis (n ¼ 15), and those who had had emergency surgery (n ¼ 28) were more likely to be in group A (P , 0.05). The mean length of stay for group A was 11.7 6 7.3 days; for group B, 5.2 6 6.3 days; the complication rate was higher in group A (group A, 38.2%; group B, 8.5%; P ¼ 0.072). The overall complication and mortality rate was 29.5% and 3.4%, respectively. CBDE can be performed safely in the elderly with accepted morbidity and mortality. The laparoscopic approach is feasible and safe in elective setting even in the elderly.

show abstract

Laparoscopic Common Bile Duct Exploration

Abstract: LCBDE during laparoscopic cholecystectomy solves 2 problems during the same anesthesia with high success rates and may be employed successfully.

Cited by 77 publications

References 31 publications

Preoperative factors predicting poor outcomes following laparoscopic choledochotomy: a multivariate analysis study

Preoperative factors predicting poor outcomes following laparoscopic choledochotomy: a multivariate analysis study

Clinical Application of Primary Suture Following Three-Port Laparoscopic Common Bile Duct Exploration: A Report of 176 Cases

Common Bile Duct Exploration in an Elderly Asian Population

Contact Info

Product

Resources

About