Impact of single‐stage laparoscopic trans‐cystic exploration on hospital procedures, admissions and length‐of‐stay in common bile duct stone clearance

2021 ◽  
Author(s):  
Anh N. Vu ◽  
Jacqueline Eskander ◽  
Steven T. F. Chan ◽  
Nezor Houli ◽  
Hai T. Bui
Keyword(s):  
Bile Duct ◽  
Length Of Stay ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone ◽  
Single Stage ◽  
Stone Clearance

scholarly journals Single Stage Management of Concomitant Cholelithiasis and Choledocholithiasis

2017 ◽  
Vol 56 (205) ◽  
pp. 117-123
Author(s):  
Mukund Raj Joshi ◽  
Tanka Prasad Bohara ◽  
Shail Rupakheti ◽  
Deepak Raj Singh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone ◽  
Single Stage ◽  
Endoscopic Management ◽  
Stage Management ◽  
Endoscopic Method ◽  
Procedural Time

Introduction: Concomitant cholelithiasis and choledocholithiasis are commonly managed in two stage procedure, endoscopic management of common bile duct stone followed by laparoscopic cholecystectomy in different time and setting. We perform these two procedures in same sitting in operating room set up. We evaluated the procedure in terms of outcome, feasibility and complications. Methods: Prospective cross-sectional study carried out since April 2013 to August 2016 in all patients who had undergone single stage endoscopic and laparoscopic management of concomitant cholelithiasis and choledocholithiasis. Patient’s demography, procedural time for different procedure and procedure in total and post-operative complications were recorded and analyzed with suitable statistical methods. Results: Out of 50 cases enrolled, 2 patients were converted to open. Out of 48 patients, 3 needed re-attempt for completion. Majority were female 36 (72%), mean age was 39.48years. Mean common bile duct diameter and mean stone size was 11.43±2.63 cm and 7.99±2.01cm, respectively. Mean of total procedural time was 90.93± 33.68 minutes. In most of the cases, laparoscopic cholecystectomy performed first followed by endoscopic method (66.7%). Total procedural time was less in the patients who underwent laparoscopy first in comparison to endoscopy first. Clinically significant complications like cholangitis, pancreatitis and duodenal perforation occurred in 7 patients. Out of 4 patients who developed pancreatitis, one had severe acute pancreatitis requiring prolonged hospitalization. Conclusion: Single stage management of common bile duct and gall bladder stone by laparoscopic and endoscopic method is feasible in our setup with acceptable results. Endoscopic treatment of common bile duct stone if performed first, is associated with longer procedural time. Keywords: choledocholithiasis; cholelithiasis; endoscopic retrograde cholangiopancreatography; laparoscopic cholecystectomy.

The clinical course of common bile duct stone clearance with endoscopic retrograde cholangio-pancreaticography*

2019 ◽  
Vol 54 (9) ◽  
pp. 1166-1171
Author(s):  
Liv Bjerre Juul Nielsen ◽  
Daniel Mønsted Shabanzadeh ◽  
Anna Aaresøn ◽  
Lars Tue Sørensen
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Clinical Course ◽  
Bile Duct Stone ◽  
Endoscopic Retrograde ◽  
Stone Clearance

scholarly journals Optimal Timing of Single-Stage Retrograde Endoscopic Common Bile Duct Stone Removal in Mild and Moderate Acute Cholangitis: A Prospective Trial

2020 ◽  
Author(s):  
Chih-Ming Liang ◽  
Yi-Chun Chiu ◽  
Lung-Sheng Lu ◽  
Cheng-Kun Wu ◽  
Fai-Meng Sou ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone ◽  
Acute Cholangitis ◽  
Single Stage ◽  
Complication Rates ◽  
Stone Extraction ◽  
Endoscopic Retrograde ◽  
Stone Removal

Abstract Background: In this study, we aimed to compare the efficacy and safety of removing a single-stage, retrograde, endoscopic common bile duct stone in patients with mild and moderate acute cholangitis associated with choledocholithiasis.Methods: We enrolled 196 endoscopic retrograde cholangiopancreatography (ERCP)-naïve patients diagnosed with acute cholangitis and choledocholithiasis between September 2018 and February 2020 at a single hospital. For eligible patients, single-stage treatment involved stone removal at initial ERCP. Early ERCP was defined as ERCP performed ≤ 72 hours following diagnosis in the emergency room.Results: The final analysis included 138 patients. The success rate of complete stone extraction was similar in patients with mild and moderate cholangitis (88.5% vs. 91.7%; p = 0. 536). Complication rates were also comparable between the two groups. In the moderate cholangitis group, the length of hospitalization declined significantly among patients who underwent early single-stage ERCP (10.6 ± 6.1 vs. 18.7 ± 12.5 days; p = 0.001) compared with patients treated with delayed ERCP. In the multivariate analysis, early ERCP indicated shorter hospitalization times (≤ 10 days) (odds ratio (OR), 7.689; p = 0.030), while endoscopic retrograde biliary drainage, for acute cholangitis only, indicated longer hospitalization times (OR, 0.358; p = 0.030). A stone size larger than 1.5 cm was an independent risk factor for stone extraction failure (OR, 24.507; p = 0.009).Conclusions: Single-stage, retrograde, endoscopic common bile duct stone removal may be safe and effective for patients with mild and moderate cholangitis. The benefit of early single-stage ERCP (≤ 72 hours) was reflected mainly by reduced hospitalization time and costs.Trial registration: ClinicalTrials.gov: NCT03754491.

Laparoscopic common bile duct stone clearance with flexible choledochoscopy

2007 ◽  
Vol 21 (12) ◽  
pp. 2317-2321 ◽  
Author(s):  
B. Topal ◽  
R. Aerts ◽  
F. Penninckx
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone ◽  
Stone Clearance
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