Laparoscopic management of common bile duct stones: Study of 13 cases

Abstract

Abstract:In recent years, laparoscopic surgery for common bile duct (CBD) stones has been gaining wider acceptance. We report our experience with the laparoscopic management of CBD stones in 16 patients (9 males and 7 females; mean age, 62 years; range, 27-81 years). We considered two options for the laparoscopic procedures: (1) transcystic CBD exploration for those patients with fewer than 3 CBD stones, 5 mm or less in diameter, in whom the diameter of the cystic duct exceeded that of the CBD stones and (2) choledochotomy with T-tube drainage for other patients, unless a preoperative percutaneous transhepatic cholangio-drainage (PTCD) tube hadbeen inserted. We successfully removed CBD stones by laparoscopic management in 13 of the 16 patients. The procedures employed were laparoscopic choledocholithotomy in 10 patients and laparoscopic transcystic CBD exploration and stone extraction in 3 patients.We converted to open choledochotomy in 3 patients, because of severe inflammation and dense adhesions due to acute cholecystitis in 2 patients and because of wide adhesions due to previous surgery in 1. We conclude that laparoscopic procedure is a safe and effective method for the removal of CBD stones.