scholarly journals ERCP Following Laparoscopic Cholecystectomy: A Safe and Effective way to Manage CBD Stones and Complications

HPB Surgery ◽  
1995 ◽  
Vol 8 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Colleen M. Schmitt ◽  
John Baillie ◽  
Peter B. Cotton
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Biliary Tree ◽  
Bile Duct Stones ◽  
Operative Complication ◽  
Cbd Stones ◽  
Bile Duct Injuries

The efficacy of ERCP in detecting and treating post-laparoscopic cholecystectomy problems was examined in a series of consecutive patients undergoing directed examination of the biliary tree over a two-year period. Three major diagnostic groups were identified: leaks and bile duct injuries (n = 9), retained common bile duct stones (n = 18), and post-cholecystectomy pain (n = 13). These diagnostic groups differed in degree of abnormal bilirubin (p = .004) and time between surgery and ERCP (p = .0005). Diagnosis of a post-operative complication was successful in 92% of attempted cases. Therapy was successful in 92% of attempted cases. Three patients developed mild pancreatitis as a result of ERCP. This series underscores the efficacy of a multi-disciplinary approach to problems which occur after laparoscopic cholecystectomy.

CONCOMITANT GALLSTONES AND COMMON BILE DUCT STONES: SHOULD SINGLE-STEP LAPAROSCOPIC CHOLECYSTECTOMY IMMEDIATELY AFTER THE ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY?

2018 ◽  
Vol 8 (6) ◽  
pp. 99-104
Author(s):  
Vy Pham Trung ◽  
Hiep Pham Nhu ◽  
Vu Pham Anh ◽  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Single Step ◽  
Bile Duct Stones ◽  
Endoscopic Retrograde ◽  
Female Ratio ◽  
Cbd Stones ◽  
Study Results

Purpose: To evaluate results from treatment of concomitant gallstones and common bile duct (CBD) stones by ERCP and laparoscopic cholecystectomy. Analysis of single-step or separated-step characteristics. Object: During the 3 years (2015-2017), 285 patients CBD stones concomitant or not gallstones underwent ERCP, 68 patients concomitant gallstones and CBD suitable criteria for inclusion at Hue Central Hospital. Retrospective clinical descriptive study. Results: Average age 52.2±12.5 (24-90), male/female ratio of 0.7/1 (27/41). Abdominal pain was the most common symptom 91.2%, jaundice 51.5%, direct bilirubin increased 27.3±15.6μmol/l (2.2-165). The diameter of CBD stone is 12.4±3.2mm (6-20), gallstones size 11.3±6.2mm (536). The first time CBD stones 95.6%, recurrence CBD stones 4.4%. ERCP and laparoscopic cholecystectomy (LC) 34patients, ERCP 1.4±2.5times and secondary LC. Single-step ductal clearance 76.5%, separatestep ductal clearance 94.1% (p=0.041). Length of hospital stay 6.5±4.3days and 13.6±2.2days (p<0.0001). Conclusions: The percentage of ductal clearance in the separate-step patients group was higher than that single-step patients group with p=0.041. The indication of cholecystectomy immediately endoscopic retrograde cholangio pancreatography should be based on the patient status, the ductal clearance as well as the complications. Key words: Common bile duct stones, Endoscopic retrograde cholangio pancreatography

scholarly journals Abordaje laparoscópico sistemático de la coledocolitiasis

2021 ◽  
Vol 113 (1) ◽  
pp. 62-72
Author(s):  
Carlos M. Canullán ◽  
◽  
Enrique J. Petracchi ◽  
Nicolás Baglietto ◽  
Hugo I. Zandalazini ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Preoperative Diagnosis ◽  
Length Of Hospital Stay ◽  
Common Bile Duct Stones ◽  
Single Stage ◽  
Bile Duct Stones ◽  
Bile Duct Injuries ◽  
Transcystic Approach

Background: The prevalence of common bile duct stones associated with cholelithiasis increases with age and is about 15 % in the 8th decade of life but its management is still controversial. Some surgeons prefer the single-stage approach with laparoscopy while others suggest the two-stage management with preoperative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy. Objective: The aim of the present study was to evaluate the efficacy of feasibility of single-stage laparoscopic surgery in patients with cholelithiasis and choledocholithiasis. Material and methods: We conducted a retrospective study with prospectively collected data between July 2008 and July 2018. Results: Of 2447 laparoscopic cholecystectomies performed during the study period, 416 presented common bile duct stones. The global success of the transcystic approach to clear common bile duct stones was 81.2%, 70.4% in the cases with preoperative diagnosis of choledocholithiasis and 92.9% for other diagnoses. The rate of complications was 4% without deaths or bile duct injuries. Conclusion: Single-stage laparoscopic surgery is an efficient and safe approach based on the high global success of transcystic exploration. The preoperative diagnosis of choledocholithiasis reduces the efficacy of the procedure due to greater indication of choledocotomy, with complications and longer length of hospital stay.

Laparoscopic Transcystic Cholangioscopic Lithotripsy for Common Bile Duct Stones During Laparoscopic Cholecystectomy

Endoscopy ◽  
1996 ◽  
Vol 28 (05) ◽  
pp. 431-435 ◽  
Author(s):  
K. Ido ◽  
N. Isoda ◽  
Y. Taniguchi ◽  
T. Suzuki ◽  
T. Ioka ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones

Positive Intraoperative Cholangiography during Laparoscopic Cholecystectomy: Is Laparoscopic Common Bile Duct Exploration Necessary?

2005 ◽  
Vol 71 (9) ◽  
pp. 750-753
Author(s):  
Gabriel Akopian ◽  
James Blitz ◽  
Thomas Vander Laan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Case Series ◽  
Common Bile Duct Stones ◽  
Common Bile Duct Exploration ◽  
Bile Duct Stones ◽  
Endoscopic Retrograde ◽  
Technical Problems ◽  
The Common

The treatment of choledocholithiasis discovered incidentally during laparoscopic cholecystectomy is not yet standardized. Options include laparoscopic common bile duct exploration (LCBDE), postoperative endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy (ERCP-ES), and no intervention. We undertook a review of our case series to determine whether LCBDE is obligatory and which LCBDE method is unsuccessful. During the 6-year study period, 91 patients with choledocholithiasis were identified. Fifty-six patients (62%) underwent LCBDE. Thirteen (23%) of these 56 patients subsequently required ERCP. Balloon sweeping of the common bile duct failed in 10 of 21 patients (48% failure) compared to any other combination of techniques with a failure rate of 1/33 (3%; P < 0.001). Two patients did not undergo complete duct exploration because of technical problems. Thirty-five patients (38%) did not undergo LCBDE. Nine of these patients (26%) did not have ERCP-ES. None of the patients who underwent postoperative ERCP-ES required additional procedures or surgery. LCBDE can successfully treat common bile duct stones, with minimal to no morbidity, but is not mandatory for safely treating choledocholithiasis. Additionally, advanced techniques for clearing the common bile duct are more successful. Surgeons should be proficient at performing these techniques.

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