Single-stage procedure for the treatment of cholecysto-choledocolithiasis: a surgical procedures review

Bove, Aldo; Renzo, Raffaella Maria Di; Palone, Gino; Testa, Domenica Carmen; Malerba, Valentina; Bongarzoni, Giuseppe

doi:10.2147/tcrm.s146461

Cited by 12 publications

(7 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Optimal management of patients with acute cholecystitis in combination with choledocholithiasis largely depends on the professional level of medical personnel, multidisciplinarity (radiologist, endoscopist, surgeon, anesthesiologist) and technical equipment of the medical institution [19]. In our practice, we did not experience difficulties in organizing the stages of OS tactics.…”

Section: Discussionmentioning

confidence: 95%

Application of one-stage surgical tactics treatment of acute cholecystitis in combination with choledocholithiasis

Nyiatovich¹,

Talgatuly²,

Duisenovich³

et al. 2022

ijhs

View full text Add to dashboard Cite

Introduction: Concrements of the common bile duct (choledocholithiasis) occur from 8% to 20% in patients with acute cholecystitis. This pathology requires simultaneous correction of the pathology of the gallbladder and the common bile duct. Methods: We retrospectively analyzed the case histories of 135 patients who underwent endoscopic retrograde cholangio pancreatography, endoscopic papillosphincterotomy, choledocholithoextraction followed by laparoscopic cholecystectomy + CHEST + LCE) for acute cholecystitis in combination with choledocholithiasis in the period from January 2016 to March 2021. Patients who underwent simultaneous treatment (ERCP + EPST + CLE + LCE under one anesthesia) were assigned to the OS group (n = 63), patients who underwent two-stage treatment (ERCP + EPST + CLE and LCE on the 3-4th day during one hospitalization) were assigned to the TS group (n = 72). All endoscopic procedures in both groups were performed by the same endoscopist using the same technique. Result: There were significant differences between the groups in terms of the duration of anesthesia, the dynamics of the decrease in the blood serum of the total bilirubin and the leukocytes range at the postoperative period, the frequency of postoperative complications and the duration of the average hospitalization in favor of one-stage treatment.

show abstract

Section: Discussionmentioning

confidence: 95%

Application of one-stage surgical tactics treatment of acute cholecystitis in combination with choledocholithiasis

Nyiatovich¹,

Talgatuly²,

Duisenovich³

et al. 2022

ijhs

View full text Add to dashboard Cite

show abstract

“…On the other hand, in UK about 61% of upper-gastrointestinal or hepatobiliarypancreatic surgeons performed laparoscopic CBD exploration (LCBDE) when a single-stage technique was pursued, 25% demanding postoperative ERCP and 13% performing either LCBDE or ERCP when they encountered CBD stones [18]. Nevertheless, the trend over the last decade continues not so much towards LCBDE utilisation in favour of endoscopic only (two-stage sequential approach) or LERV procedures, resulting in a decreased familiarity with LCBDE by senior surgeons and their trainees [10,[19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Laparoendoscopic Rendez-Vous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis

Percario,

Panaccio,

Caldarella

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: The two-stage technique combining the Endoscopic Retrograde CholangioPancreatography (ERCP) with common bile duct (CBD) clearance carried out before the laparoscopic cholecystectomy represents the most common approach for CBD stones. Over time, different techniques have been proposed to manage cholecysto- choledocholithiasis (CCL) advantageously in one stage. Among these, the laparoendoscopic rendez-vous (LERV) addresses the CCL issue with a laparoscopic cholecystectomy with insertion of a guide wire performed at initial stage of the procedure, followed by the clearance of the bile duct carried out by the endoscopists. The goal of this study was to evaluate the efficacy and safeness of LERV procedure recording results and complications, also making a comparison between our results and current literature. Methods: We reviewed our experience of all consecutive patients with cholecysto-choledocholithiasis managed with LERV between January 2018 and December 2023. LERV success rate, operative time, length of hospital stay, stone recurrence, incidence of endoscopic and surgical complications were analysed. Results: A total of 120 patients underwent LERV in our facilities. We reported a 97% LERV success rate, 1.6% conversion-to-open rate, a median intraoperative time of 122 (range 95-220) min. The median hospital stay was 4 (range 2-38) days. An overall morbidity of 15% was reported (18/120): 15 Clavien-Dindo type 1/2, 2 type 3a and one type 3b. In two cases a re-operation during the hospital stay was necessary. At a median follow-up of 14 months (3-59) five patients experienced stone recurrence requiring redo-ERCP in two cases. Conclusion: LERV offers the significant advantage of a single stage procedure and hospitalisation along with a lower risk of post-ERCP pancreatitis, failed CBD cannulation and complications. Our experience confirms safety and effectiveness of the technique for CCL management.

show abstract

“…The transcystic approach also has advantages, as reported by Bove et al such as keeping the common bile duct intact, preventing the risk of common bile duct stricture, reducing bile leakage, faster operating time, and reducing post-operative complications. 8 The minimum diameter of the common bile duct for safe laparoscopic transcholedochal is controversial. Crawford et al have asserted that a diameter exceeding 8 mm is considered safe.…”

Section: Discussionmentioning

confidence: 99%

Transcystic versus transcholedochal laparoscopic common bile duct exploration: Choosing the right approach – A Case Series

Fuadhi,

Handaya,

Barmawi

et al. 2023

JKKI

View full text Add to dashboard Cite

Laparoscopic common bile duct exploration (LCBDE) is a relevant therapeutic option in managing cholecysto-choledocholithiasis. The success of this procedure is highly dependent on selecting an appropriate method, either transcystic or transcoledocal. Intraoperative choledochoscopy proves its importance in evaluating the condition of the choledochal duct and sphincter of Oddi. In this case series, we report 2 cases of patients with complaints of right upper abdominal pain and jaundice. Both patients were diagnosed with multiple cholecysto-choledocholithiasis at Dr. Sardjito Hospital, Yogyakarta. The interventional measures applied to both patients were transcystic and transcoledocal exploration. In the first patient, the transcystic method was chosen because the cystic duct was widening up to 9 mm in diameter. While in the second patient, the transcoledocal method was taken because the diameter of the cystic duct was still within normal limits. The duration of surgery in transcystic surgery was shorter than in transcoledocal surgery, with a time ratio of 129 minutes versus 162 minutes. Postoperatively, both patients were discharged on the second day after the procedure, and both experienced recovery without any significant complications. Overall, LCBDE has been shown to be safe to perform. The one-stage surgical approach has been shown to reduce the risk of complications, cost, and duration of treatment required. The choice between the transcystic or transcoledocal method should be based on each patient’s clinical condition.

show abstract

Single-stage procedure for the treatment of cholecysto-choledocolithiasis: a surgical procedures review

Cited by 12 publications

References 69 publications

Application of one-stage surgical tactics treatment of acute cholecystitis in combination with choledocholithiasis

Application of one-stage surgical tactics treatment of acute cholecystitis in combination with choledocholithiasis

Laparoendoscopic Rendez-Vous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis

Transcystic versus transcholedochal laparoscopic common bile duct exploration: Choosing the right approach – A Case Series

Contact Info

Product

Resources

About