scholarly journals Results Obtained with the Laparoscopic Approach to the Bile Duct for the Treatment of Choledocholithiasis in 101 Cases

2021 ◽  
Vol 14 (2) ◽  
pp. 119-125
Author(s):  
Belén Martin Arnau ◽  
Manuel Rodriguez Blanco ◽  
Victor Molina Santos ◽  
Antonio Rabal Fueyo ◽  
Antonio Moral Duarte ◽  
...  
Keyword(s):  
Bile Duct ◽  
Laparoscopic Approach

Laparoscopic management of type VI choledochal cyst with common bile duct stone: report of a case and review of literature

2021 ◽  
Vol 14 (10) ◽  
pp. e244393
Author(s):  
G Revathi ◽  
Brijesh Kumar Singh ◽  
Yashwant Singh Rathore ◽  
Sunil Chumber
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Incidental Finding ◽  
Laparoscopic Approach ◽  
Biliary Colic ◽  
Type I ◽  
Laparoscopic Management ◽  
Cyst Excision

A young adult male presented with biliary colic and intermittent jaundice for 1 year. Abdomen findings were unremarkable. Routine investigations revealed a raised total bilirubin. On abdominal ultrasonography, common bile duct (CBD) dilatation with multiple stones was noted. On further imaging with magnetic resonance cholangiopancreatography, type I choledochal cyst (CDC) was suspected. A laparoscopic approach was planned. Intraoperatively, dilatation of cystic duct was noted which constitute type VI CDC. Partial malrotation of the gut and accessory right hepatic artery were also noted as incidental finding. Laparoscopic cholecystectomy with CBD exploration and removal of stones, biliary stent placement, cystic duct cyst excision and primary repair of CBD was done. Postoperatively, the patient improved symptomatically with a fall in bilirubin to normal range. We are describing the laparoscopic management of a rare case of type IV CDC which was diagnosed intraoperatively.

A simultaneous endoscopic and laparoscopic approach for management of early iatrogenic bile duct obstruction

2014 ◽  
Vol 80 (3) ◽  
pp. 511-515 ◽  
Author(s):  
Aijaz A. Sofi ◽  
Jianlin Tang ◽  
Yaseen Alastal ◽  
Ali T. Nawras
Keyword(s):  
Bile Duct ◽  
Laparoscopic Approach ◽  
Bile Duct Obstruction ◽  
Duct Obstruction

scholarly journals Comparative analysis of iatrogenic injury of biliary tract in laparotomic and laparoscopic cholecystectomy

2014 ◽  
Vol 27 (4) ◽  
pp. 272-274 ◽  
Author(s):  
André Augusto FORTUNATO ◽  
João Kleber de Almeida GENTILE ◽  
Diogo Peral CAETANO ◽  
Marcus Aurélio Zaia GOMES ◽  
Marco Antônio BASSI
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Biliary Tract ◽  
Bile Duct Injury ◽  
Laparoscopic Approach ◽  
Epidemiological Data ◽  
Iatrogenic Injury ◽  
Exclusion Criteria ◽  
Causal Factors

BACKGROUND: Iatrogenic injury to the bile ducts is the most feared complication of cholecystectomy and several are the possibilities to occur. AIM: To compare the cases of iatrogenic lesions of the biliary tract occurring in conventional and laparoscopic cholecystectomy, assessing the likely causal factors, complications and postoperative follow-up. METHODS: Retrospective cohort study with analysis of records of patients undergoing conventional and laparoscopic cholecystectomy. All the patients were analyzed in two years. The only criterion for inclusion was to be operative bile duct injury, regardless of location or time of diagnosis. There were no exclusion criteria. Epidemiological data of patients, time of diagnosis of the lesion and its location were analyzed. RESULTS: Total of 515 patients with gallstones was operated, 320 (62.1 %) by laparotomy cholecystectomy and 195 by laparoscopic approach. The age of patients with bile duct injury ranged from 29-70 years. Among those who underwent laparotomy cholecystectomy, four cases were diagnosed (1.25 %) with lesions, corresponding to 0.77 % of the total patients. No patient had iatrogenic interventions with laparoscopic surgery. CONCLUSION: Laparoscopic cholecystectomy compared to laparotomy, had a lower rate of bile duct injury.

scholarly journals Portobiliary fistula following laparoscopic cholecystectomy

2016 ◽  
Vol 98 (7) ◽  
pp. e123-e125 ◽  
Author(s):  
B Merrick ◽  
D Yue ◽  
MH Sodergren ◽  
LR Jiao
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Gold Standard ◽  
Open Surgery ◽  
Rare Complication ◽  
Laparoscopic Approach ◽  
Endoscopic Retrograde ◽  
Dual Pathology ◽  
Bile Duct Injuries ◽  
Liver Abscesses

The laparoscopic approach has replaced open surgery as the gold standard for cholecystectomy. This technique is, however, associated with a greater incidence of bile duct injuries (BDIs). We report a case of portobiliary fistula (PBF), a rare complication of BDI, occurring post laparoscopic cholecystectomy (LC). PBF has been reported after procedures such as endoscopic retrograde cholangiopancreatography and pathologies such as liver abscesses, but only once previously in the setting of LC. We discuss the management of this patient with apparent dual pathology, and summarise other aetiologies that may give rise to this condition.

scholarly journals LAPAROSCOPIC APPROACH OF THE MAIN BILE DUCT IN TREATMENT OF CHOLEDOCHOLITHIASIS. EXPERIENCE OF A BILIO-PANCREATIC UNIT

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
P Gil Vázquez ◽  
D Ferreras Martínez ◽  
B Gómez Pérez ◽  
F Sánchez-Bueno
Keyword(s):  
Cost Effectiveness ◽  
Bile Duct ◽  
Hospital Stay ◽  
Therapeutic Option ◽  
Laparoscopic Approach ◽  
Common Bile Duct Exploration ◽  
Conversion To Open Surgery ◽  
Single Center Study ◽  
Safe Technique ◽  
Effectiveness Index

Abstract INTRODUCTION The aim is to analyze the validity and safety of a new program of laparoscopic common bile duct exploration (LCBE) in the treatment of choledocholithiasis (CD), evaluating hospital stay and cost-effectiveness. MATERIAL AND METHODS Today, there is controversy over which is the best therapeutic option in choledocholithiasis: preoperative ERCP followed by laparoscopic cholecystectomy (LC) versus LCBE. We designed this prospective, non-randomized, single-center study with 118 patients (67 women and 51 men, a mean age of 69.8 ± 17.3 years old). Sixty-six patients began a two-stage management (ERCP + LC), failing to clean the bile duct by endoscopy in 15 cases. LCBE was performed in 59 patients (49 at the beginning and 11 after ERCP failure). Seven of them required conversion to open surgery. RESULTS LCBE approach was more effective in cleaning the bile duct than ERCP (88.1% vs 72.7%; p = 0.032) with no statistics differences in terms of postoperative morbidity or mortality. In the multivariate analysis, the LCBE was an independent factor in the reduction of hospital stay and the economic costs derived from the management of these patients, reducing it 6.13 days (CI95% 2.98 - 9.27; p < 0.001) the hospital stay and 3,218.16€ (CI95% 1,082.4 - 5,354.8; p = 0.001) the costs respect to the classical approach, with an incremental cost-effectiveness index (CEI) of -209. CONCLUSION LCBE is an effective and safe technique. It significantly reduces hospital stay and costs derived from the management of the patients with choledocholithiasis.

scholarly journals Laparoscopic trans-cystic common bile duct exploration and treatment of choledocholithiasis in a patient with Roux-en-Y reconstruction after gastrectomy: report of an emergency case

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
Marco Giacometti ◽  
Francesco Battafarano ◽  
Orazio Geraci ◽  
Sandro Zonta
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Total Gastrectomy ◽  
Laparoscopic Approach ◽  
Common Bile Duct Exploration ◽  
Direct Vision ◽  
Emergency Case ◽  
The Common ◽  
Reconstruction After Gastrectomy

Abstract We present the case of choledocholithiasis with purulent cholangitis treated with laparoscopic approach in a patient with Roux-en-Y reconstruction after total gastrectomy. After cholangiography, the common bile duct was explored with trans-cystic choledochoscopy and the retained stone extracted under direct vision.

scholarly journals Common Bile Duct Exploration in an Elderly Asian Population

2015 ◽  
Vol 100 (2) ◽  
pp. 261-267 ◽  
Author(s):  
Vishal G. Shelat ◽  
Vincent J. M. Chia ◽  
JeeKeem Low
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Elderly Patients ◽  
Laparoscopic Approach ◽  
Asian Population ◽  
Laparoscopic Group ◽  
The Elderly ◽  
Common Bile Duct Exploration ◽  
Group A ◽  
Group B

Common bile duct exploration (CBDE) is an accepted treatment for choledocholithiasis. This procedure is not well studied in the elderly population. Here we evaluate the results of CBDE in elderly patients (>70 years) and compare the open (group A) with the laparoscopic group (group B). A retrospective review was performed of elderly patients with proven common bile duct (CBD) stones who underwent CBDE from January 2005 to December 2009. There were 55 patients in group A and 33 patients in group B. Mean age was 77.6 years (70–91 years). Both groups had similar demographics, liver function tests, and stone size—12 mm (range, 5–28 mm). Patients who had empyema (n = 9), acute cholecystitis (n = 15), and those who had had emergency surgery (n = 28) were more likely to be in group A (P < 0.05). The mean length of stay for group A was 11.7 ± 7.3 days; for group B, 5.2 ± 6.3 days; the complication rate was higher in group A (group A, 38.2%; group B, 8.5%; P = 0.072). The overall complication and mortality rate was 29.5% and 3.4%, respectively. CBDE can be performed safely in the elderly with accepted morbidity and mortality. The laparoscopic approach is feasible and safe in elective setting even in the elderly.

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