Prospective Randomized Trial of LC+LCBDE vs ERCP/S+LC for Common Bile Duct Stone Disease

Rogers, Stanley J.; Cello, John P.; Horn, Jan K.; Siperstein, Allan; Schecter, William P.; Campbell, Andre R.; Mackersie, Robert C.; Rodas, Alex; Kreuwel, Huub T. C.; Harris, Hobart W.

doi:10.1001/archsurg.2009.226

Cited by 275 publications

(232 citation statements)

References 22 publications

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“…This has further been proved in subsequent studies [13,14]. The hospital stay and the total treatment cost were, however, significantly less with the one-stage laparoscopy group prompting the authors to recommend the latter as the procedure of choice [9,10]. It is obvious that longer hospital stay, as well the resultant increase in the treatment cost, is the fall out of the staged procedure.…”

Section: Discussionmentioning

confidence: 81%

“…This entails involvement of two teams led by the endoscopist and surgeon for CBD stones and gallstones, respectively. The endoscopic approach has been found to be similar to laparoscopic CBD exploration in terms of successful stone clearance, morbidity, and mortality except for longer hospital stay [9,10]. The latter disadvantage can be countered by carrying out the endoscopic CBD stone clearance as a single-sitting procedure in conjunction with LC [11].…”

mentioning

confidence: 99%

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‘Single-Sitting’ Laparoscopic Cholecystectomy and Endoscopic Removal of Common Bile Duct Stone for Cholelithiasis and Choledocholithiasis: a Feasibility Study

Ibrarullah¹,

Mishra²,

Dash³

et al. 2013

Indian J Surg

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'Single-sitting' laparoscopic cholecystectomy followed by endoscopic common bile duct clearance is emerging as a viable option for management of cholelithiasis and concomitant choledocholithiasis. The only disadvantage of the procedure is logistical since it requires co-ordination between two teams-the surgeons and the endoscopists. This limitation can be overcome in centres where both the procedures are performed by one team. With a considerable experience in endoscopy, we conducted a prospective study in a select group of patients to assess the feasibility of this single-sitting approach. The study included 38 patients with a radiological diagnosis of choledocholithiasis or jaundice at presentation. After laparoscopic cholecystectomy, the patients were turned prone and subjected to endoscopic retrograde cholangiogram, sphincterotomy and extraction of the common bile duct stone. The procedure was successful in 33 (87 %) of patients. The mean procedure time and hospital stay were 2 h, 20 min and 2 days, respectively. None of the patients had any major complications. We conclude that in a select group of patients, single-sitting laparoscopic cholecystectomy followed by endoscopic clearance of the common bile duct stone is safe and effective.Keywords Choledocholithiasis . CBD Stone . Laparoscopic Cholecystectomy Common bile duct (CBD) stone occurs in about 3-15 % of patients undergoing laparoscopic cholecystectomy (LC) [1][2][3]. In the era of open cholecystectomy, preoperative endoscopic clearance of CBD followed by open cholecystectomy was comparable [4][5][6] or even considered inferior [7] to single-stage cholecystectomy and choledocholithotomy. With minimally invasive surgery becoming the 'gold standard,' the endoscopic approach has seen a revival and has been considered a viable alternative to laparoscopic CBD exploration for concomitant CBD stone. Traditionally, gallstones with CBD stones are managed in two sittings i.e., endoscopic clearance of CBD stone followed by laparoscopic cholecystectomy or vice versa [8]. This entails involvement of two teams led by the endoscopist and surgeon for CBD stones and gallstones, respectively. The endoscopic approach has been found to be similar to laparoscopic CBD exploration in terms of successful stone clearance, morbidity, and mortality except for longer hospital stay [9,10]. The latter disadvantage can be countered by carrying out the endoscopic CBD stone clearance as a single-sitting procedure in conjunction with LC [11]. The single-sitting approach, however, suffers from the logistic problem as it requires proper coordination between the surgeon and the endoscopist. We were encouraged to try this approach because of our considerable experience with both laparoscopy as well as endoscopy. We attempted to perform laparoscopic cholecystectomy as well as endoscopic clearance of the CBD stone ourselves without having the need to involve another team. In this report, we have presented our initial experience with this 'single-sitting' approach with respect to its...

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Section: Discussionmentioning

confidence: 81%

mentioning

confidence: 99%

‘Single-Sitting’ Laparoscopic Cholecystectomy and Endoscopic Removal of Common Bile Duct Stone for Cholelithiasis and Choledocholithiasis: a Feasibility Study

Ibrarullah¹,

Mishra²,

Dash³

et al. 2013

Indian J Surg

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“…In all of these studies, laparoscopic cholecystectomy and bile duct exploration decreased the duration of hospitalization when compared with endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (ES) performed before or after LC. In addition, the cost was less when a single-stage procedure was utilized (LC with bile duct exploration) compared with a two-stage procedure (ES before or after LC) [32,33]. Other outcomes, such as duct clearance and complications, were equivalent between the two approaches.…”

Section: Laparoscopic Cholecystectomy and The Common Bile Duct Stonementioning

confidence: 98%

“…Single-center, single-surgeon series demonstrate the efficiency gained with this strategy [29]. Several randomized clinical trials have addressed the proper management of CBD stones in association with LC [30][31][32]. In all of these studies, laparoscopic cholecystectomy and bile duct exploration decreased the duration of hospitalization when compared with endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (ES) performed before or after LC.…”

Section: Laparoscopic Cholecystectomy and The Common Bile Duct Stonementioning

confidence: 99%

Laparoscopic cholecystectomy: first, do no harm; second, take care of bile duct stones

et al. 2013

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“…EUS and MR allow detection of CBD stones with sensitivity and specificity both over 90 %, avoiding unnecessary bile duct exploration [76]. If the diagnosis of CBD stones is confirmed, they can be managed by preoperative endoscopic retrograde cholangiopancreatography (ERCP) [77], laparoscopic CBD clearance during cholecystectomy (laparoscopic or combined laparoendoscopic ''rendezvous'') [78,79], or at the next best opportunity. Two meta-analyses showed no differences when preoperative ERCP was compared to intraoperative removal of CBD stones (LE 1b) [80,81].…”

Section: Acute Pancreatitismentioning

confidence: 99%

Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

et al. 2012

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Background In January 2010, the SICE (Italian Society of Endoscopic Surgery), under the auspices of the EAES, decided to revisit the clinical recommendations for the role of laparoscopy in abdominal emergencies in adults, with the primary intent being to update the 2006 EAES indications and supplement the existing guidelines on specific diseases. Methods Other Italian surgical societies were invited into the Consensus to form a panel of 12 expert surgeons. In order to get a multidisciplinary panel, other stakeholders involved in abdominal emergencies were invited along with a patient's association.

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Prospective Randomized Trial of LC+LCBDE vs ERCP/S+LC for Common Bile Duct Stone Disease

Abstract: clinicaltrials.gov Identifier: NCT00807729.

Cited by 275 publications

References 22 publications

‘Single-Sitting’ Laparoscopic Cholecystectomy and Endoscopic Removal of Common Bile Duct Stone for Cholelithiasis and Choledocholithiasis: a Feasibility Study

‘Single-Sitting’ Laparoscopic Cholecystectomy and Endoscopic Removal of Common Bile Duct Stone for Cholelithiasis and Choledocholithiasis: a Feasibility Study

Laparoscopic cholecystectomy: first, do no harm; second, take care of bile duct stones

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