Laparoscopic Treatment for Unsuspected Common Bile Duct Stones by Transcystic Sphincter of Oddi Pneumatic Balloon Dilation and Pressure‐Washing Technique

Masoni, L.; Mari, Francesco Saverio; Pietropaolo, Vincenzo; Onorato, Maurizio; Meucci, Massimo; Brescia, Antonio

doi:10.1007/s00268-013-1992-y

Cited by 16 publications

(16 citation statements)

References 46 publications

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“…Additionally, previous authors have reported the feasibility of one‐stage procedures using the same concept as our LTPBD+LC for CCL patients, 25,26 and our results corroborate those of these previous studies. Given the advantages of LTPBD+LC, the procedure seems most suitable for patients with CCL who could not be treated by ERCP or who have severe ASA‐PS scores, such as patients with previous gastrectomy.…”

Section: Discussionsupporting

confidence: 90%

“…Given the advantages of LTPBD+LC, the procedure seems most suitable for patients with CCL who could not be treated by ERCP or who have severe ASA‐PS scores, such as patients with previous gastrectomy. Also, surgical outcomes of our procedure in patients with CCL who had undergone previous gastrectomy were similar to those of previous LTPBD studies 25,26 …”

Section: Discussionsupporting

confidence: 79%

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One‐stage fluoroscopy‐guided laparoscopic transcystic papillary balloon dilation and laparoscopic cholecystectomy in patients with cholecystocholedocholithiasis who previously had undergone gastrectomy for gastric cancer

Kamada

Ohdaira

Takeuchi

et al. 2020

Asian J Endoscop Surgery

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Background Patients with a history of gastrectomy have a higher incidence of cholecystocholedocholithiasis (CCL) and related morbidities than the general population. However, the management of common bile duct (CBD) stones with endoscopic retrograde cholangiopancreatography is challenging in patients after Roux‐en‐Y or Billroth II reconstruction because of the altered gastrointestinal anatomy. The aim of the current study was to evaluate the safety and efficacy of one‐stage laparoscopic transcystic papillary balloon dilation and laparoscopic cholecystectomy (LTPBD+LC) in patients with previous gastrectomy for gastric cancer. Methods This retrospective cohort study included five patients with CCL who had previously undergone gastrectomy. All five underwent LTPBD+LC between May 2015 and February 2020 at our institution. The primary end‐point was complete clearance of the CBD stones. Results Of the 311 patients who had undergone gastrectomy for gastric cancer from December 2009 to December 2018 at our institution, six (1.9%) were later diagnosed with CCL. Five of the six patients did not need emergency biliary drainage and underwent conservative therapy and subsequent elective LTPBD+LC. LTPBD+LC was successfully performed in all cases. None of the patients required conversion to open surgery. The rate of complete clearance of the CBD stones was 100%. The mean operative time of the entire procedure was 126 minutes (range, 102‐144 minutes), and the mean blood loss was 12.4 mL (range, 1‐50 mL). There were no major perioperative complications, and the mean length of postoperative hospital stay was 4.2 days (range, 3‐7 days). Conclusion One‐stage LTPBD+LC may be a feasible procedure for patients with CCL who have previously undergone gastrectomy for gastric cancer.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 79%

One‐stage fluoroscopy‐guided laparoscopic transcystic papillary balloon dilation and laparoscopic cholecystectomy in patients with cholecystocholedocholithiasis who previously had undergone gastrectomy for gastric cancer

Kamada

Ohdaira

Takeuchi

et al. 2020

Asian J Endoscop Surgery

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“…CBD clearance was found to be alleviated by flushing saline after anterograde balloon dilatation of the Oddi sphincter or after glucagon injection, but these methods are described in singular trials and confirmatory studies are needed [35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Endoscopy First and Laparoscopic Cholecystectomy First Strategies for Patients With Gallstone Disease and Intermediate Risk of Choledocholithiasis: Protocol for a Clinical Randomized Controlled Trial (Preprint)

Aleknaite¹,

Simutis²,

Stanaitis³

et al. 2020

Preprint

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BACKGROUND The optimal approach for patients with gallbladder stones and intermediate risk for choledocholithiasis still remains undetermined. Use of diagnostic endoscopic retrograde cholangiopancreatography should be minimized as it carries considerable risk of post-procedural complications. OBJECTIVE This study compares two different management strategies: intraoperative cholangiography and endoscopic ultrasound before laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis and intermediate risk for choledocholithiasis. METHODS It is a diagnostic randomized active-controlled single-center clinical trial enrolling adult patients undergoing laparoscopic cholecystectomy due to symptomatic gallbladder stones with intermediate risk for choledocholithiasis. The risk for choledocholithiasis is calculated using an original prognostic score – Vilnius University Hospital Index. A total of 106 participants will be included and randomized into two groups. Evaluation of bile ducts using endoscopic ultrasound and endoscopic retrograde cholangiography on demand will be performed before laparoscopic cholecystectomy for one arm (“Endoscopy first”). Intraoperative cholangiography during laparoscopic cholecystectomy and postoperative endoscopic retrograde cholangiopancreatography on demand will be administered in another arm (“Cholecystectomy first”). Postoperative follow-up is 6 months. RESULTS The primary endpoint is the length of hospital stay. Secondary endpoints will include accuracy of the different management strategies, adverse events of interventions, duct clearance and technical success of interventions (intraoperative cholangiography, endoscopic ultrasound, endoscopic retrograde cholangiography), costs of treatment. CONCLUSIONS This trial is planned determine which strategy is better approach for a patient with intermediate common bile duct stones risk and to define a simple to calculate and safe algorithm on managing choledocholithiasis. CLINICALTRIAL The trial is registered at ClinicalTrials.gov, identification number NCT03658863.

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“…There are other technical aids which are useful in trans-cystic clearance: in the presence of small stones (<0.6 cm), some authors undertook trans-cystic pneumatic dilation of the papilla to facilitate the expulsion of the stones. 32 …”

Section: Methodsmentioning

confidence: 99%

Single-stage procedure for the treatment of cholecysto-choledocolithiasis: a surgical procedures review

Bove

Renzo

Palone

et al. 2018

TCRM

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While laparoscopic cholecystectomy is generally accepted as the treatment of choice for simple gallbladder stones, in cases in which common bile duct stones are also present, clinical and diagnostic elements, along with intraoperative findings, define the optimal means of treatment. All available options must be accessible to the surgical team which must necessarily be multidisciplinary and include a surgeon, an endoscopist, and a radiologist in order to identify the best option for a truly personalized surgery. This review describes the different techniques and approaches used based on distinctive recommendations and factors, according to the specific cases treated and the results achieved.

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Laparoscopic Treatment for Unsuspected Common Bile Duct Stones by Transcystic Sphincter of Oddi Pneumatic Balloon Dilation and Pressure‐Washing Technique

Abstract: Treatment of unsuspected CBDS detected by intraoperative cholangiography during LC with this original technique was safe and effective and a viable alternative of the transcystic endoscopic approach.

Cited by 16 publications

References 46 publications

One‐stage fluoroscopy‐guided laparoscopic transcystic papillary balloon dilation and laparoscopic cholecystectomy in patients with cholecystocholedocholithiasis who previously had undergone gastrectomy for gastric cancer

One‐stage fluoroscopy‐guided laparoscopic transcystic papillary balloon dilation and laparoscopic cholecystectomy in patients with cholecystocholedocholithiasis who previously had undergone gastrectomy for gastric cancer

Comparison of Endoscopy First and Laparoscopic Cholecystectomy First Strategies for Patients With Gallstone Disease and Intermediate Risk of Choledocholithiasis: Protocol for a Clinical Randomized Controlled Trial (Preprint)

Single-stage procedure for the treatment of cholecysto-choledocolithiasis: a surgical procedures review

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