Laparoscopic exploration of common bile duct in difficult choledocholithiasis

Tai, C K; Tang, Chung‐Ngai; Ha, J P Y; Chau, Chun Han; Siu, Wing Tai; Li, M. K. W.

doi:10.1007/s00464-003-8216-8

Cited by 60 publications

(54 citation statements)

References 16 publications

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“…23 Studies evaluating complication rates in a operative-based approach for the management of obstructive choledochal stone disease report similar numbers, with complication rate ranging from 5% to 20%. 24,25 In the current study, patients initially admitted to a surgical service had significantly more complications during their index admission compared to those admitted to medicine. As these patients are also more likely to undergo an operative procedure-both cholecystectomy as a singlestaged approach as well as cholecystectomy with perioperative ERCP and/or ES-the greater complication rate for a patient admitted to a surgical team is not unexpected.…”

Section: Discussionmentioning

confidence: 93%

Effect of Medical or Surgical Admission on Outcome of Patients with Gallstone Pancreatitis and Common Bile Duct Stones

LaFemina

Sokal

Chang

et al. 2008

Journal of Gastrointestinal Surgery

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Section: Discussionmentioning

confidence: 93%

Effect of Medical or Surgical Admission on Outcome of Patients with Gallstone Pancreatitis and Common Bile Duct Stones

LaFemina

Sokal

Chang

et al. 2008

Journal of Gastrointestinal Surgery

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“…LCBDE is associated with successful stone clearance rates ranging from 85 to 95%, a morbidity rate of 4–16% and a mortality rate of around 0–2% [6,7]. Tai et al [34] reported that the clearance rate was 100%, and no recurrence was discovered during a mean follow-up period of 16 months. Moreover, LCBDE avoids the short-term (pancreatitis, bleeding and perforation), medium (cholangitis and recurrent stone formation) and long-term (bile duct malignancy) adverse effects of ES.…”

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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“…Schreurs et al showed 75%–84% patients undergoing ERCP/EST had no symptoms with up to 70-month followup [75]. Complications of ERCP include bleeding, duodenal perforation, cholangitis, pancreatitis, and bile duct injury [76]. Moreover, ERCP is not possible in 3% to 10% of all patients [77].…”

Section: Treatmentmentioning

confidence: 99%

“…Laparoscopic exploration is very effective for clearing difficult CBD stones. Tai et al reported that the clearance rate was 100%, and no recurrence was discovered during a mean followup period of 16 months [76]. Golipour et al showed LCBDE to be an effective procedure as the initial modality of management for acute gallstone cholangitis [92].…”

Section: Treatmentmentioning

confidence: 99%

Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

Shojaiefard

Esmaeilzadeh

Ghafouri

et al. 2009

Gastroenterology Research and Practice

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Common bile duct stones (CBDSs) may occur in up to 3%–14.7% of all patients for whom cholecystectomy is preformed. Patients presenting with CBDS have symptoms including: biliary colic, jaundice, cholangitis, pancreatitis or may be asymptomatic. It is important to distinguish between primary and secondary stones, because the treatment approach varies. Stones found before, during, and after cholecystectomy had also differing treatments. Different methods have been used for the treatment of CBDS but the suitable therapy depends on conditions such as patient' satisfaction, number and size of stones, and the surgeons experience in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD exploration (transcystic or transcholedochal), or laparotomy with CBD exploration (by T-tube, C-tube insertion, or primary closure) are the most commonly used methods managing CBDS. We will review the pathophysiology of CBDS, diagnosis, and different techniques of treatment with especial focus on the various surgical modalities.

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Laparoscopic exploration of common bile duct in difficult choledocholithiasis

Abstract: When ERCP is impossible or stone retrieval is incomplete, LECBD is the solution to difficult CBD stones.

Cited by 60 publications

References 16 publications

Effect of Medical or Surgical Admission on Outcome of Patients with Gallstone Pancreatitis and Common Bile Duct Stones

Effect of Medical or Surgical Admission on Outcome of Patients with Gallstone Pancreatitis and Common Bile Duct Stones

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

Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

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