Evaluating the results of laparoscopic surgery for common bile duct stones

Tóm tắt Đặt vấn đề: Đánh giá kết quả phẫu thuật nội soi điều trị sỏi đường mật. Phương pháp nghiên cứu: Nghiên cứu hồi cứu mô tả trên 203 người bệnh, được chẩn đoán sỏi đường mật chính, được phẫu thuật nội soi lấy sỏi tại Bệnh viện Hữu nghị Đa khoa Nghệ An từ 01/01/2014 đến 01/06/2019. Kết quả: Tổng số 203 người bệnh với 74 nam (36,5%), 129 nữ (63,5%); độ tuổi trung bình 63,62 ± 17,7 (17 - 94) tuổi. Phẫu thuật mở ống mật chủ lấy sỏi, dẫn lưu Kehr 43,8%; mở ống mật chủ + dẫn lưu Kehr + cắt túi mật 44,8%; mở ống mật chủ + khâu kín ống mật chủ 3,9%; chuyển mổ mở 7,4%. Thời gian phẫu thuật 85,2 ± 15,7 phút (64 - 156 phút), thời gian hậu phẫu 5,7 ± 1,07 ngày. Biến chứng chung sau phẫu thuật là 5,5%. Kết luận: Phẫu thuật mở ống mật chủ (OMC) nội soi điều trị sỏi đường mật an toàn, hiệu quả. Abstract Introduction: Evaluation of the results of laparoscopic treatment for common bile duct stones. Materials and Methods: Retrospective descriptive study of 203 patients diagnosed the common bile duct stones, underwent laparoscopic surgery from January 2014 to June 2019 in Nghe An Friendship General Hospital. Results: There were total 203 patients including 74 men (36,5%), 129 women (63,5%); mean age was 63,62 ± 17,7 (17 - 94). Biliary drainage by T tube after choledochotomy was in 43,8%; Biliary drainage with T tube after choledochotomy associated with cholecystectomy was in 44,8%; Choledochotomy without drainage was in 3,9%. The convert to laparotomy was (7,4%). The operative time was 85,2 ± 15,7 minutes (64-156 minutes). Postoperative length stay was 5,7 ± 1,07 days. The morbidity rate was 5,5%. Conclusion: Choledochotomy by laparoscopic surgery for common bile duct stones was feasible and effective. Keywords: Laparoscopic surgery, common bile duct stones, gallbladder stones.

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Laparoscopic Management of Common Bile Duct Stones: Transpapillary Stenting or External Biliary Drainage?

JSLS Journal of the Society of Laparoendoscopic Surgeons ◽

10.4293/jsls.2014.00277 ◽

2014 ◽

Vol 18 (4) ◽

pp. e2014.00277 ◽

Cited By ~ 4

Author(s):

Agustin Dietrich ◽

Fernando Alvarez ◽

Nicolas Resio ◽

Oscar Mazza ◽

Eduardo de Santibañes ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Biliary Drainage ◽

Common Bile Duct Stones ◽

Bile Duct Stones ◽

Laparoscopic Management ◽

External Biliary Drainage

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Abordaje laparoscópico sistemático de la coledocolitiasis

Revista Argentina de Cirugía ◽

10.25132/raac.v113.n1.1501.ei ◽

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.

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The Role of Endoscopic Biliary Drainage without Sphincterotomy in Gallstone Patients with Cholangitis and Suspected Common Bile Duct Stones Not Detected by Cholangiogram or Intraductal Ultrasonography

Gut and Liver ◽

10.5009/gnl16234 ◽

2017 ◽

Vol 11 (3) ◽

pp. 434-439 ◽

Cited By ~ 1

Author(s):

Hyeon Jeong Goong ◽

Jong Ho Moon ◽

Yun Nah Lee ◽

Hyun Jong Choi ◽

Seo-Youn Choi ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Biliary Drainage ◽

Common Bile Duct Stones ◽

Bile Duct Stones ◽

Endoscopic Biliary Drainage ◽

Intraductal Ultrasonography

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Primary closure of the common bile duct in open laparotomy for common bile duct stones

Journal of Hepato-Biliary-Pancreatic Surgery ◽

10.1007/s00534-005-1097-6 ◽

2006 ◽

Vol 13 (5) ◽

pp. 398-402 ◽

Cited By ~ 10

Author(s):

Masato Yamazaki ◽

Hideki Yasuda ◽

Souichirou Tsukamoto ◽

Yoshio Koide ◽

Tsutomu Yarita ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Primary Closure ◽

Common Bile Duct Stones ◽

Bile Duct Stones ◽

Open Laparotomy ◽

The Common

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

The American Surgeon ◽

10.1177/000313480507100911 ◽

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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