The Safety and Efficacy of Laparoscopic Common Bile Duct Exploration Combined with Cholecystectomy for the Management of Cholecysto-choledocholithiasis

Long, Ping; Chen, Mingyu; Ji, Lin; Zheng, Longbo; Yan, Peijian; Fang, Jing; Zhang, Bin; Cai, Xiujun

doi:10.1097/sla.0000000000002731

Cited by 130 publications

(94 citation statements)

References 37 publications

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“…Due to the potential seriousness of biliary complications, it begs the question of the current global approach to intra-operative cholangiography and single stage bile duct clearance. A recent meta-analysis by Pan et al [84] found performance of intra-operative cholangiography to have superior outcomes in managing cholecystocholedocholithiasis.…”

Section: Discussionmentioning

confidence: 99%

Readmission to hospital following laparoscopic cholecystectomy: a meta-analysis

McIntyre¹,

Johnston²,

Foley³

et al. 2020

ait

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Biliary disease and cholecystitis remain one of the most significant surgical challenges. Over 1,000,000 cholecystectomies are performed in the US every year [1, 2], and over 50,000 in the UK [3]. While minimally invasive laparoscopic cholecystectomy (LC) has afforded great advantages over open cholecystectomy, reducing variability and improving outcomes remains a challenge [4, 5]. It is only recently that operative classifications and grading of cholecystitis have been published [6]. LC related peri-operative complications, while infrequent may

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Section: Discussionmentioning

confidence: 99%

Readmission to hospital following laparoscopic cholecystectomy: a meta-analysis

McIntyre¹,

Johnston²,

Foley³

et al. 2020

ait

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“…A recent meta‐analysis showed that LCBDE had a higher stones clearance rate, lower retained stone rate and lithiasis recurrence rate and lower hospital stays and less total charges than the ERCP procedure. Thus, the LCBDE should be considered the optimal treatment choice for the patient with cholecysto‐choledocholithiasis …”

Section: Discussionmentioning

confidence: 99%

Clinical role of frequency‐doubled double‐pulse neodymium YAG laser lithotripsy for removal of difficult biliary stones in laparoscopic common bile duct exploration

Yang

et al. 2019

ANZ Journal of Surgery

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Background: The optimal methods for patients with difficult biliary stones remain under debate. The aim of this study was to evaluate the role of frequency-doubled double-pulse neodymium YAG (FREDDY) laser lithotripsy for removing difficult biliary stones during laparoscopic common bile duct exploration (LCBDE). Methods: Between March 2013 and January 2015, 42 consecutive patients with difficult biliary stones who underwent LCBDE with FREDDY laser lithotripsy were included in this study. The clinical data of all patients were retrospectively collected and analysed. Results: Bile ducts were completely cleared in all patients. The complications related to laser lithotripsy were not noted. A total of 38 patients (90.5%) underwent primary closure of common bile duct, and T-tube drainage was applied to four patients (9.5%). No bile duct injury, bleeding and perforation were observed. There were no post-operative surgery-related deaths. Bile leakage occurred in four patients (9.5%) with primary closure procedure, and all of them were managed successfully with conservative therapy. The median follow-up period was 42.8 months, with no evidence of bile duct stricture and stone recurrence in all patients. Conclusions: The LCBDE combined with FREDDY laser lithotripsy appear to be effective and safe for the treatment of difficult biliary stones.

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“…The treatment of CBDS largely varies. It is still controversial whether there is any treatment superior to the others . Laparoscopic surgery or ERCP alone may not achieve the best therapeutic effect.…”

Section: Discussionmentioning

confidence: 99%

“…It is still controversial whether there is any treatment superior to the others. [4][5][6] Laparoscopic surgery or ERCP alone may not achieve the best therapeutic effect. A reasonable combination of laparoscopy, choledochoscopy and duodenoscopy could maximize the benefit.…”

Section: Discussionmentioning

confidence: 99%

T‐tube‐free single‐incision laparoscopic common bile duct exploration plus cholecystectomy: a single centre experience

Yao

Tian

Yao

et al. 2019

ANZ Journal of Surgery

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Background The present study aimed to explore the indications and feasibility of T‐tube‐free trans‐umbilical single‐incision laparoscopic common bile duct exploration (SILCBDE) plus laparoscopic cholecystectomy (LC) for treating choledocholithiasis. Methods Patients hospitalized in the Second Affiliated Hospital (Shengjing Hospital) of China Medical University from January 2010 to January 2017 with the diagnosis of common bile duct stones and treated with T‐tube‐free trans‐umbilical single‐incision LC plus common bile duct exploration were retrospectively analysed. Results A total of 37 male/female choledocholithiasis patients (mean age 65 years, range 29–86) were treated with T‐tube‐free trans‐umbilical SILCBDE plus LC. No intraoperative complication or conversion to open surgery occurred in any of the cases. The mean operative time was 99.8 min (range 84–125) for endoscopic nasobiliary drainage group (n = 6), 113.8 min (range 70–150) for endoscopic retrogradebiliary drainage group (n = 2), 131.1 min (range 75–161) for pigtail J‐tube group (n = 24), 113.7 min (range 100–150) for primary closure group (n = 5). The mean post‐operative hospital stay length was 5.5 days (range 4–7) for endoscopic nasobiliary drainage group, 12.5 days (range 10–15) for endoscopic retrogradebiliary drainage group, 6.5 days (range 4–10) for J‐tube group, 5.8 days (range 4–9) for primary closure group. Pancreatitis, bile leakage and peritonitis were not presented in any of the group. After 17–101 months follow‐up, three patients presented recurrent common bile duct stones. Conclusion In selected cases, T‐tube‐free trans‐umbilical SILCBDE plus LC is feasible and safe for experienced surgeons, and can achieve similar therapeutic effects as common LC plus common bile duct exploration procedures.

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The Safety and Efficacy of Laparoscopic Common Bile Duct Exploration Combined with Cholecystectomy for the Management of Cholecysto-choledocholithiasis

Abstract: The updated meta-analysis first confirms that LCBDE+LC is superior to pre-EST+LC both in perioperative safety and short- and long-term postoperative efficacy, which should be considered as optimal treatment choice for cholecysto-choledocholithiasis.

Cited by 130 publications

References 37 publications

Readmission to hospital following laparoscopic cholecystectomy: a meta-analysis

Readmission to hospital following laparoscopic cholecystectomy: a meta-analysis

Clinical role of frequency‐doubled double‐pulse neodymium YAG laser lithotripsy for removal of difficult biliary stones in laparoscopic common bile duct exploration

T‐tube‐free single‐incision laparoscopic common bile duct exploration plus cholecystectomy: a single centre experience

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