One-Session Laparoscopic Management of Combined Common Bile Duct and Gallbladder Stones Versus Sequential ERCP Followed by Laparoscopic Cholecystectomy

Mohamed, Moharram A; Ammar, Mohamed Sabry; Nassar, Ahmad H M

doi:10.1089/lap.2014.0582

Cited by 13 publications

(11 citation statements)

References 11 publications

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“…In the study of Mohamed et al, 87% presented with acute biliary pain with jaundice, 8% presented with acute pancreatitis while 6% presented only with jaundice. 11 Tan et al reported the initial presentations of 60.0% with right hypochondrial pain and 46.0% with jaundice. Acute cholangitis accounted for 32% of the emergency presentations, followed by acute pancreatitis in 10.0% and acute cholecystitis in 10.0%.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of different methods of laparoscopic treatment of common bile duct stones

2019

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Background: Common bile duct (CBD) stones are the second most common complication of gall bladder stones. The best management of patients with CBD stones remains controversial. The aim of this study was to evaluate the methods of laparoscopic CBD exploration (LCBDE).Methods: This prospective study was conducted on 30 patients with CBD stones through 2 years. CBD stricture was excluded. Authors used transcystic and transcholedochotomy approaches for LCBDE either with or without choledoschope. Primary repair of the choledochotomy incision was done. Results: The mean age was 48.90±11.84 years. Biliary colic was the presentation in 63.3% of patients. The transcystic approach for CBD exploration was used in 16 cases without conversion, 11 cases were completed without choledochoscope, while 5 cases with choledochoscopic guided extraction. Choledochotomy approach had been used in 13 cases, 6 cases were completed with choledochoscope and 7 cases without it, two cases of them failed. One case failed from the beginning and was converted to open exploration. 5 ERCP previously inserted stents were removed. The mean operative time was 162.33±74.67 min. Bile leakage occurred in 2 cases following the choledochotomy approach. The mean hospital stay was 3.37±1.38 days.Conclusion: LCBDE is a feasible, effective and safe approach to bile duct stones. Depending on proper training and gaining experience.

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Section: Discussionmentioning

confidence: 99%

Evaluation of different methods of laparoscopic treatment of common bile duct stones

2019

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“…None of the 25 studies reported mean BMI. Only one study 20 reported the preoperative laboratory investigation (median (range) bilirubin concentration for LTCE 20 (6-74) μmol/l and Reference Gigot et al 31 Millat et al 34 Arvidsson et al 20 Martin et al 33 Lauter and Froines 24 Tokumura et al 40 Waage et al 42 Jameel et al 22 Zhang et al 19 Hongjun et al 18 Aawsaj et al 28 Overall Heterogeneity: 31 Arvidsson et al 20 Martin et al 33 Lauter and Froines 24 Tokumura et al 40 Waage et al 42 Zhang et al 19 Overall Phillips et al 36 Millat et al 34 Berthou et al 29 Michel et al 25 Topal et al 41 Tan et al 39 Santo et al 38 Mohamed et al 35 Rhodes et al 37 Cuschieri et al 30 Phillips et al 36 Gigot et al 31 Millat et al 34 Berthou et al 29 Martin et al 33 Tokumura et al 40 Waage et al 42 Jameel et al 22 Tai et al 23 Tan et al 39 Zhang et al 19 Aawsaj et al 28 Overall Hongjun et al 18 Berthou et al 29 Martin et al 33 Overall Hongjun et al 18 Reference...…”

Section: Resultsmentioning

confidence: 99%

“…The median quality score for the RCTs was judged based on the Cochrane Handbook 13 . The quality assessment stratifies the current evidence and projects the need for further research on the topic based on the quality of the available evidence into: high-quality evidence where further research is not expected to change the current confidence in the estimate of the effect size, moderate-quality evidence if further research is likely to influence confidence in the estimated effect and may change it; low-quality evidence if further research is very likely to influence confidence in the estimate of Reference Design n-RCT Phillips et al 36 Gigot et al 31 Millat et al 34 Arvidsson et al 20 Berthou et al 29 DePaula et al 27 Martin et al 33 Lauter and Froines 24 Michel et al 25 Tokumura et al 40 Waage et al 42 Topal et al 41 Jameel et al 22 Tan et al 39 Santo et al 38 Dimov et al 26 Darrien et al 21 Mohamed et al 35 Zhang et al 19 Aawsaj et al 28 Rhodes et al 37 Cuschieri et al 30 Grubnik et al 32 Overall n-RCT heterogeneity: I 2 = 68%, P < 0·05 RCT heterogeneity: I 2 = 72% P < 0·05 Heterogeneity: 2 Forest plot for successful duct clearance in patients with choledocholithiasis undergoing a laparoscopic transcystic or transcholedochal approach. Studies that had 100 per cent success in both arms 18,23 were not included in the analysis, so calculation of an odds ratio was not possible in the pooled analysis.…”

Section: Quality Assessmentmentioning

confidence: 99%

Meta‐analysis of laparoscopic transcysticversustranscholedochal common bile duct exploration for choledocholithiasis

et al. 2019

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Background It is not clear whether laparoscopic transcystic exploration (LTCE) laparoscopic choledochotomy (LCD) is superior in the management of choledocholithiasis. In this meta‐analysis, the success of LTCE versus LCD was evaluated. Methods Cochrane Central Register of Controlled Trials, Web of Science, Trip, PubMed, Ovid and Embase databases were searched systematically for relevant literature up to May 2017. Studies that compared the success rate of LTCE and LCD in patients with choledocholithiasis were included. PRISMA guidelines were followed. Multiple independent reviewers contributed on a cloud‐based platform. Random‐effects model was used to calculate odds ratios (ORs) or standardized mean differences (MDs) with 95 per cent confidence intervals. An a priori hypothesis was generated based on clinical experience that LTCE is as successful as LCD. Results Of 3533 screened articles, 25 studies comprising 4224 patients were included. LTCE achieved a lower duct clearance rate than LCD (OR 0.38, 95 per cent c.i. 0·24 to 0·59). It was associated with a shorter duration of surgery (MD −0·86, 95 per cent c.i. −0·97 to −0·77), lower bile leak (OR 0·46, 0·23 to 0·93) and shorter hospital stay (MD −0·78, −1·14 to −0·42) than LCD. There was no statistically significant difference in conversion, stricture formation or reintervention rate. Conclusion LCD has a higher rate of successful duct clearance, but is associated with a longer duration of surgery and hospital stay, and a higher bile leak rate.

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“…This two-stage approach has some disadvantages, including the risk of CBD stone passage taking place between ERCP and LC or during LC due to excessive gallbladder handling. These potential problems can be avoided by using the single-session laparoscopic approach for managing CBD stones during LC by transcystic exploration (TCE) or laparoscopic CBD exploration (LCBDE), which is as safe and effective as the ‘gold standard’ sequential ERCP followed by LC with the nearly same rate of success, length of hospital stay, and rate of complications [ 10 ]. In this study, we used a trans-gastrointestinal tract cholecystoscopy technique in treating GB disease without cholecystectomy, which may be superior in reduction of residual scarring and in preserving of gallbladder function.…”

Section: Discussionmentioning

confidence: 99%

“…The aim of this study was to evaluate this trans-gastrointestinal tract cholecystoscopy technique in treating gallbladder (GB) disease without the need for cholecystectomy. We also combined both endoscopic sphincterotomy (EST) and cholecystolithotomy into a one-session treatment for those patients who have both gallstones and common bile duct stones, which could potentially become another popular alternative to LC plus LCBDE [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound-assisted transmural cholecystoduodenostomy or cholecystogastrostomy as a bridge for per-oral cholecystoscopy therapy using double-flanged fully covered metal stent

Guo

Sun

et al. 2016

BMC Gastroenterol

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BackgroundLaparoscopic cholecystectomy (LC) has become the ‘gold standard’ for the treatment of symptomatic gallstones. Innovative methods are being introduced, and these procedures include transgastric or transcolonic endoscopic cholecystectomy. However, before clinical implementation, instruments still need modification, and a more convenient treatment is still needed. Moreover, some gallbladders still have good functionality and cholecystectomy may be associated with various complications. The aim of this study was to evaluate the trans-gastrointestinal tract cholecystoscopy technique in the treatment of gallbladder disease without cholecystectomy.MethodEndoscopic ultrasound (EUS)-guided cholecystoduodenostomy or cholecystogastrostomy with the placement of a double-flanged fully covered metal stent was performed and endoscopic sphincterotomy (EST) was also performed during this procedure for those patients with accompanying common bile duct stones. One or two weeks later the stent was removed and an endoscope was advanced into the gallbladder via the fistula, and cholecystolithotomy or polyp resection was performed. Four weeks later gallbladder was assessed by abdominal ultrasound.ResultsEUS guided cholecystoduodenostomy (n = 3) or cholecystogastrostomy (n = 4) with double flanged mental stent deployment was successfully performed in all of 7 patients. After the procedure, fistulas had formed in each of the patients and the stents were removed. Endoscopic cholecystolithotomy(7) and polyps resection(2) were successfully performed through the fistulas. Common bile duct stones were also successfully removed in 5 patients. The ultrasound examination of the gallbladder 4 weeks later showed no stones remaining and also showed satisfactory functioning of the gallbladder.ConclusionThe EUS-guided placement of a novel metal stent is a safe and simple approach for performing an endoscopic cholecystoduodenostomy or cholecystogastrostomy, which can subsequently allow procedures to be performed for treating biliary disease, including cholecystolithotomy.

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One-Session Laparoscopic Management of Combined Common Bile Duct and Gallbladder Stones Versus Sequential ERCP Followed by Laparoscopic Cholecystectomy

Abstract: The single-session laparoscopic management of CBD stones is as safe and effective as the gold standard sequential ERCP followed by LC with nearly the same rate of success, hospital stay, and complications.

Cited by 13 publications

References 11 publications

Evaluation of different methods of laparoscopic treatment of common bile duct stones

Evaluation of different methods of laparoscopic treatment of common bile duct stones

Meta‐analysis of laparoscopic transcysticversustranscholedochal common bile duct exploration for choledocholithiasis

Endoscopic ultrasound-assisted transmural cholecystoduodenostomy or cholecystogastrostomy as a bridge for per-oral cholecystoscopy therapy using double-flanged fully covered metal stent

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