Management of suspected common bile duct stones in children: role of selective intraoperative cholangiogram and endoscopic retrograde cholangiopancreatography

Mah, Doug; Wales, Paul W.; Njere, Ike; Kortan, Paul P.; Masiakos, Peter T.; Kim, Peter C.W.

doi:10.1016/j.jpedsurg.2004.02.019

Cited by 42 publications

(20 citation statements)

References 15 publications

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“…With the sequential approach it could be a renewed passage of stones in the CBD if the ERCP-ES is performed prior to cholecystectomy but moreover ERCP-ES could be unnecessary if performed after LC as stones can often pass spontaneously [25] . These risks are confirmed by a recent analysis of management of suspected CBD stones in children [26] that clearly shows the poor results and pitfalls of the two common sequential pathways of ERCP-ES. If performed prior to LC a total of 71% of ERCP were unnecessary and 7% failed.…”

Section: Discussionmentioning

confidence: 76%

Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work

G¹,

Barbagallo²,

Blasi³

et al. 2008

WJG

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AIM:To investigate our clinical experience with combined laparo-endoscopic Rendezvous (RV) for the treatment of patients affected by gallstones and common bile duct (CBD) stones and especially to study the never evaluated opinion of the endoscopist concerning the difficulty of the intraoperative endoscopic procedure during the RV in comparison with standard endoscopic retrograde cholangio-pancreatography (ERCP). METHODS:Eighty consecutive patients affected by cholecystolithiasis and diagnosed or suspected CBD stones were treated with a standardized "tailored" RV. The relevant technical features, the feasibility, the effectiveness in stone clearance, the safety but also the simple evaluation of difficulty and agreement of the endoscopist were analyzed with a questionnaire. R E S U LT S :T h e f e a s i b i l i t y w a s 9 7. 5 % a n d t h e effectiveness 100% concerning CBD clearance and solution of coexisting problems at the papilla. Minor morbidity was 3.3%, the operating time was prolonged by a mean of 14 min, the mean hospital stay was 3.8 d and only one stone's recurrence occurred. The endoscopist evaluated the procedure to be simpler than standard ERCP-ES in 81.2% of the cases. C O N C L U S I O N :S i m u l t a n e o u s R V c a r r i e s h i g h effectiveness and safety at least comparable to those reported for other options. The endoscopist is very often satisfied with this approach because of the minimization of some steps of the endoscopic procedure and avoidance of relevant iatrogenic risk factors. If the mandatory collaboration between surgeons and endoscopists is guaranteed, this approach can often be preferable for the patient, the surgeon, the endoscopist and the hospital.

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Section: Discussionmentioning

confidence: 76%

Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work

G¹,

Barbagallo²,

Blasi³

et al. 2008

WJG

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show abstract

“…Moreover, unlike what is observed in adults, CBD stones in children usually pass spontaneously without any significant complication [8,9]. When ERCP failed to remove the stones, even surgery with opening of the CBD was not successful and RYH was required.…”

Section: Discussionmentioning

confidence: 97%

“…This situation, however, is different in the era of laparoscopic cholecystectomy (LC) and even more because of pediatric endoscopic retrograde cholangiopancreatography (ERCP). Laparoscopic IOC and CBD exploration, although feasible, are not easy to perform, require expertise, and may be time consuming [7][8][9]. Furthermore, this procedure may lead to the conversion of an LC into an open and unnecessary CBD exploration, considering the 20.0% to 25.0% false-positive rate of IOC [10] and the possibility of a stone migrating spontaneously through the papilla and into the duodenum.…”

mentioning

confidence: 99%

Management of gallstone disease in children: a new protocol based on the experience of a single center

Tannuri

Leal

Velhote

et al. 2012

Journal of Pediatric Surgery

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“…A recent study analyzing the management of suspected CBD stones in children [58] showed clearly the poor results and pitfalls of the two common sequential pathways of ERCP-ES. If performed before LC, 71% of ERCPs were unnecessary, and 7% failed.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous laparoendoscopic rendezvous for the treatment of cholecystocholedocholithiasis

Barbagallo

Miceli

et al. 2009

Surg Endosc

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There is confusion concerning the definitions and techniques of RV due to differences in combining surgical and endoscopic steps of the procedure. The results are at least comparable with those of the other available approaches. The effectiveness of RV is greater with reciprocal implementation of surgical and endoscopic procedures. The morbidity and the risk of iatrogenic damage seem lower than with ERCP-ES and the risk of residual stones lower than with TL treatment. The RV procedure is safe and can sometimes be the preferable option, but collaboration between surgeon and endoscopist is mandatory.

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Management of suspected common bile duct stones in children: role of selective intraoperative cholangiogram and endoscopic retrograde cholangiopancreatography

Cited by 42 publications

References 15 publications

Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work

Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work

Management of gallstone disease in children: a new protocol based on the experience of a single center

Simultaneous laparoendoscopic rendezvous for the treatment of cholecystocholedocholithiasis

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