Contemporary management of concomitant gallstones and common bile duct stones: a survey of Spanish surgeons

Jorba, Rosa; Pavel, Mihai-Calin; Llàcer-Millán, Erik; Estalella, Laia; Achalandabaso, Mar; Julià-Verdaguer, E.; Nve, Esther; Padilla-Zegarra, Erlinda D; Badia, Josep M.; O’Connor, Donal B; Memba, Robert

doi:10.1007/s00464-020-07984-9

Cited by 16 publications

(14 citation statements)

References 53 publications

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“…Gallstone is a common clinical gallbladder disease, mainly manifested as biliary colic, continuous distention pain, right upper abdominal pain, etc. [ 1 ]. Relevant studies have shown that about 10% ∼ 15% of patients with cholecystolithiasis are also complicated with extrahepatic bile duct stones, which requires timely treatment; otherwise, it is likely to lead to a liver abscess, cirrhosis, acute bile duct obstruction, and other serious complications, increasing the difficulty of clinical treatment [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Endoscopic Retrograde Cholangiopancreatography Lithotomy Combined with Laparoscopic Cholecystectomy on Pain and Prognosis of Patients with Gallstones and Extrahepatic Bile Duct Stones

Zhao

Zhang

2022

Computational Intelligence and Neuroscience

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Objective. The researchers aim to assess how endoscopic retrograde cholangiopancreatography lithotomy and laparoscopic cholecystectomy affected pain and prognosis in individuals with gallstones and extrahepatic bile duct stones. Methods. Researchers studied 100 persons with gallstones and extrahepatic bile duct stones from January 2016 to August 2021. They were split into two groups: control and observation. The control group underwent open cholecystectomy + choledocholithotomy + T-tube drainage. There were ERCP + lithotomy + Laparoscopic cholecystectomy procedures conducted on the observation group of patients (LC). The operation time, incision size, and bleeding volume; stone clearance rate and stone recurrence rate; visual analogue scale (VAS); Eating time, exhaust time, out of bed activity time, and postoperative hospital stay; the two groups’ difficulties were contrasted and studied. Results. The observation group’s operation duration was much longer than the control group’s, and the incision size and bleeding volume were significantly reduced in the observation group. When it came to recurrence, there was a significant difference between the observation group (2.0%) and the control group (4.0%), even though stone clearance did not differ substantially (20.00%). The VAS scores 3 and 7 days after surgery were significantly different between the observation and control groups. The observation group’s eating time, exhaustion, activity time, and postoperative hospital stay were much shorter than the control group’s; complications occurred at a lower rate (20%) in the observation group than in the control group (34%). Conclusion. When gallstones and extrahepatic bile-duct stones are removed using laparoscopic lithotomy and laparoscopic cystoscopy (LC), the operation indices are improved and the risk of recurrence of stones is reduced and reducing the occurrence of complications, all of which improve patient outcomes and deserve to be considered a clinical reference.

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Section: Introductionmentioning

confidence: 99%

Effect of Endoscopic Retrograde Cholangiopancreatography Lithotomy Combined with Laparoscopic Cholecystectomy on Pain and Prognosis of Patients with Gallstones and Extrahepatic Bile Duct Stones

Zhao

Zhang

2022

Computational Intelligence and Neuroscience

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“…Jorba et al 19 recently reported a survey on the contemporary management of concomitant gallstones and common bile duct stones in Spain. The study found that the use of LBDE is limited, despite many surgeons indicating that they would be keen on having it implemented, thus showing the lack of training.…”

Section: Discussionmentioning

confidence: 99%

“…The study found that the use of LBDE is limited, despite many surgeons indicating that they would be keen on having it implemented, thus showing the lack of training. Unlike our study, where centers with experience were targeted, the Jorba et al survey 19 included many centers with little experience in LBDE (89% of the centers that responded performed less than 10 cases per year).…”

Section: Discussionmentioning

confidence: 99%

Multi‐institutional expert update on the use of laparoscopic bile duct exploration in the management of choledocholithiasis: Lesson learned from 3950 procedures

López-López

Gil-Vazquez

Ferreras

et al. 2022

J Hepato Biliary Pancreat

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“…19 Surveys conducted by different surgical associations show that 71%-85% of surgeons' respondents would opt for the traditional two stage ERCP followed by LC treatment of choledocholithiasis with gallbladder in situ. [20][21][22][23] The main reasons behind that being the lack of training and skills with the laparoscopic approach. 22 There have been several published systematic reviews of randomized trials that compare a single-stage vs the traditional two-stage approach that support the safety and costeffectiveness of the former.…”

Section: F I G U R Ementioning

confidence: 99%

“…[20][21][22][23] The main reasons behind that being the lack of training and skills with the laparoscopic approach. 22 There have been several published systematic reviews of randomized trials that compare a single-stage vs the traditional two-stage approach that support the safety and costeffectiveness of the former. 7,[24][25][26] A recent meta-analysis has demonstrated that the LCBDE is superior to two-stage treatment (ERCP + LC) in both, rates of technical failure, perioperative and postoperative outcomes.…”

Section: F I G U R Ementioning

confidence: 99%

Learning curve for performing laparoscopic common bile duct exploration in biliary surgery 2.0 era

Durán

Silvestre

Hernández

et al. 2022

J Hepato Biliary Pancreat

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Background Recent trials and metanalysis have demonstrated the favorable results of laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) for the treatment of cholecysto‐choledocholithiasis. The aim of this study was to evaluate the LC + LCBDE learning curve including transcystic and transductal approaches and its effect on the outcomes. Methods We identified all unselected patients who underwent LC + LCBDE by a single surgeon between May 2017 and July 2021. Pre‐, intra‐, and postoperative data were analyzed using the cumulative sum (CUSUM) analysis to evaluate the learning curve. Results A total of 110 patients were included. Total postoperative complications rate was 12.7%, including bile leakage in six (5.5%) patients. Mean length of hospital stay was 2.7 (1‐14) days. No patient had conversion to open surgery. The CUSUM graph divided the learning curve into three distinct phases: (1) Learning (1–38), (2) Competence (39–61) and (3) Proficiency (62–110). There was a significant increase in the transcystic approach rate with each phase (44.7% vs 73.9% vs 98%; P < .001). A significant decrease in the operative time (150.9 vs 117.6 vs 99.9 min; P < .001) and complication rate (21.1% vs 21.7% vs 2%; P = .01) were observed across the three phases. Conclusion Our data suggest that the learning curve for complete competence in LC + LCBDE is approximately 60 cases, provided that proper training is available. The initial learning phase can be carried out safely and efficiently with acceptable results.

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Contemporary management of concomitant gallstones and common bile duct stones: a survey of Spanish surgeons

Cited by 16 publications

References 53 publications

Effect of Endoscopic Retrograde Cholangiopancreatography Lithotomy Combined with Laparoscopic Cholecystectomy on Pain and Prognosis of Patients with Gallstones and Extrahepatic Bile Duct Stones

Effect of Endoscopic Retrograde Cholangiopancreatography Lithotomy Combined with Laparoscopic Cholecystectomy on Pain and Prognosis of Patients with Gallstones and Extrahepatic Bile Duct Stones

Multi‐institutional expert update on the use of laparoscopic bile duct exploration in the management of choledocholithiasis: Lesson learned from 3950 procedures

Learning curve for performing laparoscopic common bile duct exploration in biliary surgery 2.0 era

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