Management of impacted common bile duct stones during a laparoscopic procedure: A Retrospective Cohort Study of 377 Consecutive Patients

Abstract

Rational utilization of laser lithotripsy and an appropriate basket in LCBDE may avoid conversion to open procedures in patients with impacted CBD stones.

Surgical (Open and laparoscopic) management of large difficult CBD stones after different sessions of endoscopic failure: A retrospective cohort study

“…Furthermore, It provides unrestricted visualization of the biliary system, allows retrieval of difficult stones located in the extra-hepatic or intra-hepatic biliary tree, and carries a higher clearance rate than the trans-cystic approach. [ 1 , 29 , 32 ]Similarly, we started performing LCBDE recently, where Our LCBDE after ERCP failure was through LCD. In the same line, after ERCP failure, most LCBDE procedures (96%) were performed via choledochotomy in Tang and Li, 2005 [ 26 ] study, and 27.7% of LCDs were referred from the gastroenterology unit after one or more failed trials at endoscopic clearance of difficult stones in Paganini et al, 2005 [ 61 ] study.…”

“…However, LCD stone clearance rate after ERCP failure was 62.5%, 64.51%, and 100% in Karaliotas et al, 2015 [ 28 ], Karaliotas et al, 2008 [ 41 ], and Karunadasa et al, 2016 [ 63 ] studies respectively, and it was 95.65% when performed after ERCP failure in non-dilated CBD in Jinfeng et al, 2016 [ 32 ] study, while it was 83.3% for impacted stones in Khan et al, 2015 [ 64 ] study. On the other hand, LCD stone clearance rate ranged between 82% and 100% in Mattila et al, 2017 [ 65 ], Quaresima et al, 2017 [ 4 ] Tokumura et al, 2002 [ 66 ], Grubnik et al, 2012 [ 67 ], Jinfeng et al, 2016 [ 1 ], Jinfeng et al, 2016 [ 32 ], Khaled et al, 2013 [ 68 ], Zhou et al, 2017 [ 15 ], Zhan et al, 2016 [ 7 ], and Vindal et al, 2015 [ 69 ] studies.…”

“…Lastly, laparoscopic HJ was done by 4.0 polydioxanone (PDS) sutures (posterior and anterior interrupted sutures) and a tube drain was placed near the anastomosis and removed days after the operation ( Fig. 2 ) [ 1 , 14 , 31 , 32 ].…”

“…The incidence of common bile duct stones (CBDS) in patients with symptomatic cholelithiasis varies widely in the literature between 5% and 33% according to age [ [1] , [2] , [3] , [4] , [5] ]. CBDS are either primary (originating within the CBD) or secondary (originating in the gallbladder) and pass into the CBD [ 6 , 7 ].…”

Comparison of pre-operative ultrasonography and magnetic resonance cholangiopancreatography with intra-operative surgical findings among patients suspicious to choledocholithiasis.

“…Number of documented cases of choledocholithiasis is continuously increasing in the developing countries owing partly to the availability of improved imaging facilities 3 .The majority of common bile duct stones is formed within the gallbladder and then migrates down through the cystic duct to common bile duct 4 .According to the site of formation of common bile duct stones, it is of two types; primary stones(found rarely) which is formed in bile duct and secondary CBD(Common Bile Duct) stones, which passes into the common bile duct through cystic duct. Studies have shown that the biliary tract stones were complicated by concomitant gallstones in 15-20% of patients 5 . It was estimated that 3-33%of all patients with symptomatic cholelithiasis harbor concomitant CBD stones 6.…”