Making common duct exploration common-balloon sphincteroplasty as an adjunct to transcystic laparoscopic common bile duct exploration for pediatric patients

Rauh, Jessica L.; Ganapathy, Aravindh S; Bosley, Maggie E.; Rangecroft, Alexa; Zeller, Kristen A.; Sieren, Leah M.; Petty, John K.; Pranikoff, Thomas; Neff, Lucas P.

doi:10.1016/j.jpedsurg.2022.09.016

Cited by 6 publications

(1 citation statement)

References 22 publications

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“…Ji et al [ 21 ] also showed that LC + LCBDE is associated with a lower risk of biliary leakage, similar to our findings. The relatively high risk of postoperative complications related to ERCP + LC may be due to the sphincter of Oddi incision during the surgical procedure, which may cause changes in the biliary tract structure that negatively affect the natural defense mechanism of the bile duct, leading to adverse events, such as pancreatitis, hyperamylasemia, BTI, and bile leakage[ 22 , 23 ]. The LC + LCBDE approach, as a one-time operation, circumvents the high surgical risk of two procedures in the ERCP + LC approach and preserves duodenal papilla function, thus avoiding the structural changes to the bile duct related to the papillotomy and infections caused by retrograde flow of intestinal juice[ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of laparoscopic cholecystectomy plus cholangioscopy for the treatment of cholecystolithiasis combined with choledocholithiasis

Liu,

Chen,

et al. 2024

World J Gastrointest Surg

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BACKGROUND Currently, endoscopic retrograde cholangiopancreatography (ERCP) plus laparoscopic cholecystectomy (LC) is the main treatment for cholecystolithiasis combined with choledocholithiasis. However, the treatment is unsatisfactory, and the development of better therapies is needed. AIM To determine the clinical efficacy of LC plus cholangioscopy for cholecystolithiasis combined with choledocholithiasis. METHODS Patients (n = 243) with cholecystolithiasis and choledocholithiasis admitted to The Affiliated Haixia Hospital of Huaqiao University (910th Hospital of Joint Logistic Support Force) between January 2019 and December 2023 were included in the study; 111 patients (control group) underwent ERCP + LC and 132 patients (observation group) underwent LC + laparoscopic common bile duct exploration (LCBDE). Surgical success rates, residual stone rates, complications (pancreatitis, hyperamylasemia, biliary tract infection, and bile leakage), surgical indicators [intraoperative blood loss (IBL) and operation time (OT)], recovery indices (postoperative exhaust/defecation time and hospital stay), and serum inflammatory markers [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were compared. RESULTS No significant differences in surgical success rates and residual stone rates were detected between the observation and control groups. However, the complication rate, IBL, OT, postoperative exhaust/defecation time, and hospital stays were significantly reduced in the observation group compared with the control group. Furthermore, CRP, TNF-α, and IL-6 Levels after treatment were reduced in the observation group compared with the levels in the control group. CONCLUSION These results indicate that LC + LCBDE is safer than ERCP + LC for the treatment of cholecystolithiasis combined with choledocholithiasis. The surgical risks and postoperative complications were lower in the observation group compared with the control group. Thus, patients may recover quickly with less inflammation after LCBDE.

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