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.

scholarly journals ROLE OF EARLY LAPAROSCOPIC CHOLECYSTECTOMY IN PREVENTING COMPLICATIONS OF ACUTE CHOLECYSTITIS

2020 ◽  
pp. 1-3
Author(s):  
Mukesh Kumar ◽  
Sanjay Kumar Suman ◽  
Pawan Kumar Jha ◽  
Debarshi Jana
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Conservative Treatment ◽  
Common Bile Duct ◽  
Acute Cholecystitis ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone ◽  
The Other ◽  
Study Results ◽  
Delayed Group

Background: Cholecystectomy is the standard and the only curative treatment for acutecholecystitis. The complications of acute cholecystitis are disastrous to the patients; on the other hand, conservative treatment is associated with recurrence of symptoms and other complications as common bile duct stone. The aim of this study is to weight out the complication of emergency surgery against the complications of conservative treatment in patients with acute cholecystitis. Materials andmethods: A total of 80 patients were included in the study. All Patients underwent early laparoscopiccholecystectomy or interval laparoscopic cholecystectomies for acute calcularcholecystitis from October 2017 to September 2019 were included in the study. Results: The overall complication rate was 15% (6 of 40 in early group and 10% (4 of 40) in the delayed group. One case of delayed group suffering recurrent acute attack and the other one suffering common bile duct stone, there was no major bile duct injury in the delayed group. Conclusion: Laparoscopic cholecystectomy is a safe and cost-effective approach for the treatment of acute cholecystitis within 72 h after the onset of attack.

Unsuspected common bile duct stone encountered at laparoscopic cholecystectomy

1995 ◽  
Vol 108 (4) ◽  
pp. A1220
Author(s):  
C.A. Floresguerra ◽  
I Ponce ◽  
S.A. Copeland ◽  
I.W. Browder
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone

scholarly journals Endoscopic management of a difficult common bile duct stone

2008 ◽  
Vol 53 (3) ◽  
pp. 105 ◽  
Author(s):  
CAH Liyanage ◽  
Y Sadakari ◽  
J Lenaga ◽  
R Tanabe ◽  
S Takahata ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone ◽  
Endoscopic Management

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.

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