A Randomized, Clinical Trial to Compare Endoscopic Sphincterotomy and Subsequent Laparoscopic Cholecystectomy with Primary Laparoscopic Bile Duct Exploration During Cholecystectomy in Higher Risk Patients with Choledocholithiasis

Abstract

There was no difference between approaches to duct clearance in terms of postoperative stay, complications, or conversion in higher risk patients, but the laparoscopic approach was more effective and efficient and avoided unnecessary procedures.

A study of preoperative factors associated with a poor outcome following laparoscopic bile duct exploration

“…However, its efficiency and safety in the elderly age group and those with comorbidities remains debatable. It is interesting to note that your own study had brought out that laparoscopic CBD exploration is equally safe in the elderly [2].…”

Controversy and progress for treatment of acute cholangitis after Tokyo Guidelines (TG13)

“…The two procedures for uncomplicated gallstones and CBD stones had nearly similar complication rates, which were 7 and 11.1% (p > 0.05), respectively. Noble et al (28) described enhanced attainment rates for laparoscopic versus endoscopic management even for higher-risk patients in complications and hospital stay. Difficulty with cannulation and impacted stones represent the common causes of failure with ERC procedures (28,29).…”

“…Noble et al (28) described enhanced attainment rates for laparoscopic versus endoscopic management even for higher-risk patients in complications and hospital stay. Difficulty with cannulation and impacted stones represent the common causes of failure with ERC procedures (28,29). The main reason for unsuccessful clearance following ERC was impacted stones in 13.1% of the patients (26).…”

Training vs practice: A tale of opposition in acute cholecystitis

“…In conjunction with intraoperative biliary ductal imaging, LCBDE allows for the management of common bile duct stones during one procedure. This technique has been shown to have a statistically significant reduction in total costs, length of hospital stay from 98 h with ERCP to 55 h, and number of procedures performed [19,20] . In addition, a trend towards better ductal clearance has been demonstrated [19] .…”