Percutaneous transcystic removal of gallbladder and common bile duct stones: a narrative review

2021 ◽  
pp. 028418512110069
Author(s):  
Andrew MacCormick ◽  
Paul Jenkins ◽  
Nelofer Gafoor ◽  
David Chan

The incidence of gallstone-related complications is rising, thus leading to increases in waiting list times for elective laparoscopic cholecystectomy (LC). Percutaneous cholecystostomy (PC) provides immediate biliary drainage and may be used as an emergency option in a critically unwell patient as a bridge to surgery, or as the management option of a patient who is not fit for surgery. However, a significant number of these patients may be readmitted after PC with recurrent acute cholecystitis or pancreatitis, leading to significant morbidity and mortality. The aim of the present review was to analyze the available literature surrounding the use of the transcystic approach, including the extraction and balloon expulsion method, in the management of patients with gallbladder stones and/or common bile duct (CBD) stones. The full text of 18 articles were reviewed, of which four were included in this review. Results showed an overall success rate of CBD stone extraction in 118 of 139 patients (84.9%), gallbladder stone extraction in 97 of 114 (85.0%), and CBD stone expulsion in 27 of 29 (93.1%). Percutaneous CBD and gallbladder stone extraction may be a safe management option for elderly or co-morbid patients who are not appropriate for surgical intervention. However, the evidence base surrounding this is very limited; therefore, further research is required in order to evaluate this in more detail.

2021 ◽  
Vol 8 (12) ◽  
pp. 3692
Author(s):  
Alaaeldin Mohamed Sedik ◽  
Abrar Hussein ◽  
Abdelmajid Alshimary ◽  
Mostafa Elsayed ◽  
Ahmed Alzayed ◽  
...  

The incidence of Common bile duct stones (CBD) in patients undergoing cholecystectomy is 10%. The present-day management of common bile duct stone may be pre-, intra-, or post-operative Endoscopic retrograde cholangio-pancreatography (ERCP) with stone extraction. The reported complications of ERCP and CBD stone extraction range from 5 to 10% cases, that might be life threatening. Herein, we reported a case of calculus obstructive jaundice and cholangitis. Unfortunately, trials for ERCP and stone retrieval was followed by impacted Dormia basket which was successfully managed by surgerys.


2019 ◽  
Vol 6 (5) ◽  
pp. 1783 ◽  
Author(s):  
Cherring Tandup ◽  
Lileswar Kaman ◽  
Saroj Kant Sinha

The incidence of associated common bile duct stones in patients undergoing cholecystectomy is 10%. The present day management of common bile duct stone is pre- or post-operative endoscopic retrograde cholangio-pancreatography and clearance of common bile duct. Complications of ERCP and CBD stone extraction have been reported to occur in 5 to 10% cases which may range from mild to life threatenin Here we report a case of cholelithiasis with choledocholithiasis with obstructive jaundice and patient while undergoing ERCP and stone retrieval had complication of impacted dormia basket which was managed by surgery. 


2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Callum Jones ◽  
Helena Barton ◽  
Samir Pathak ◽  
Jonathan Rees

Abstract Background MRCP (Magnetic resonance cholangiopancreatography) is used most to assess the biliary tree for stones or strictures. Recently, MRCP availability has increased, and it is extensively used to detect of common bile duct (CBD)stones although very frequently no stones are seen. Indeed, the currently recruiting sunflower RCT aims to determine the clinical and cost effectiveness of expectant management versus MRCP in patients undergoing laparoscopic cholecystectomy at low or moderate risk of common bile duct stones. However, it is critical when requesting an investigation that adequate information is provided.  This work aimed, to describe the adequacy of information provided and correlate this with the MRCP result. We hypothesised that the less information that was provided the more common a normal result would be. Methods For a three month period (January 2021 to April 2021) all MRCP requests to detect the presence of a CBD stone were reviewed and data obtained from the Radiology CRIS (CDN Radiology Information System, CDN, Sydney, Aus.). The requesting information was compared to three pre-defined criteria (CBD diameter, presence of gallstones and LFT details) that were agreed as the optimal information that a reporting radiologist would require. The number of key pieces of information for each request and whether the request identified a CBD stone were identified. The proportion of MRCPs detecting a CBD stone was calculated according to the number of key pieces of information provided.     Results 56 patients were identified, of which 16 (29%) patients had CBD stones. In 24/56 (43%) patients the presence of gallstones on a previous ultrasound was provided, 14/56 (25%) of patients had information about LFTs including bilirubin and a trend in LFTs was not stated for any patient (0/56; 0%).  The rate of stone detection was calculated by the number of pieces of information provided. The rate was 71% (5/7) when all 3 pieces of data were provided, 31% (2/13) when two piece of information were provided, 30% (8/27) when a single piece of information was provided, and only 11% (1/11) when none of the specified data were provided. Conclusions It is uncommon for adequate clinical information to be provided in MRCP requests and in 16% of request no key information was provided. The LFT results were frequently omitted and the trend in LFTs never stated. The more key data provided in the request saw a higher proportion of MRCPs where a CBD stone was identified. We recommend that maximal clinical information is mandated for MRCP request perhaps using mandatory fields on electronic requesting systems and that  these systems are also used to facilitate recruitment to clinical trials such the Sunflower RCT.


BMC Surgery ◽  
2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Wei-jie Zhang ◽  
Gui-fang Xu ◽  
Qin Huang ◽  
Kun-lun Luo ◽  
Zhi-tao Dong ◽  
...  

2019 ◽  
Vol 6 (5) ◽  
pp. 1447
Author(s):  
Ahmed M. Abdelaziz Hassan ◽  
Ayman M. Abdelaziz ◽  
Mohamed Emad Esmat ◽  
Hussam Hamdy ◽  
Magdy M. Elsebae

Background: Still there is no standard technique for managing patients with concomitant gallbladder (GB) and common bile duct stones (CBDS). In this work, we report our experience of the management for gallstone disease and biliary duct calculi as a single stage treatment.Methods: Forty Patients with symptomatic gall bladder calcular disease and suspected CBDS were enrolled in the study. The outcome measures were operating time, CBD stone clearance, postoperative morbidity and mortality, the need to conversion to other techniques and hospital stay.Results: They were 13 males and 27 females of median age 43 years old. Intra opertative cholangiography (IOC) revealed single CBD stone in twenty-eight, two stones in eleven and three stones in only one of the patients. The mean operating time had been 175 min. There were no intraoperative complications with a mean hospital stay was 1.8 days (range, 1-4 days).Conclusions: One-stage lapro-endoscopic procedure in the management for gallstone disease and biliary duct calculi is safe and efficient in CBD stone clearance. It is preferred when facilities and experience in endoscopic therapy exist.


2013 ◽  
Vol 59 (4) ◽  
pp. 857-864 ◽  
Author(s):  
Guodong Li ◽  
Qiuping Pang ◽  
Xiujuan Zhang ◽  
Haiyan Dong ◽  
Rong Guo ◽  
...  

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