High rate of stone-related complications after stapling the cystic duct during laparoscopic cholecystectomy—an underrecognized risk

Thomas, Alexander S.; Gleit, Zachary L.; Younan, Stephanie; Genkinger, Jeanine M.; Kluger, Michael D.

doi:10.1007/s00464-023-09947-2

Cited by 3 publications

References 31 publications

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Safety and efficacy of using stapler device for wide cystic duct ligation in acute setting of laparoscopic cholecystectomy

Alyami,

Alotaibi,

Alhoumaily

et al. 2024

Sci Rep

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This research explores the challenges posed by variations in cystic duct anatomy during laparoscopic cholecystectomy and the potential use of stapler devices to address such complexities. It aims to assess the safety and efficacy of stapler devices, particularly in cases involving short, and wide cystic duct. The study, conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia, between 2021 and 2023. The study design involved a retrospective cohort approach, and the sample size encompassed all cases meeting the inclusion criteria during the study period. Data was analyzed using SPSS program. The study involving 568 patients, with the predominant technique for ligation being clipping (89.3%). The primary indication for using the Endo GIA stapler was a wide cystic duct (6.2%). Analysis revealed a significant association between stapler device use and hypertension ( p = 0.042), diabetes ( p = 0.001), CKD ( p = 0.011), and obstructive jaundice ( p = 0.006). Multivariate regression demonstrated that older patients were 2.1 times more likely to use stapler devices (AOR = 2.125; p = 0.039), while those with obstructive jaundice had a 2.2 times higher likelihood (AOR = 2.168; p = 0.049). Throughout the years, metal clips have shown the best prognosis compared to any other method for securing the cystic duct during closure in laparoscopic cholecystectomy. However, to avoid incomplete sealing of wide, short, or inflamed ducts, other instruments have emerged as possible alternatives for such conditions. Use of Endo-GIA is a safe and effective method for patients with wide, short cystic duct. Selective usage of endo-GIA is considered cost effective and may add a positive impact in decreasing post operative biliary leak.

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Safety and efficacy of using stapler device for wide cystic duct ligation in acute setting of laparoscopic cholecystectomy

Alyami,

Alotaibi,

Alhoumaily

et al. 2024

Sci Rep

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Intraoperative diagnosis of choledocholithiasis by endoscopic ultrasound

Shadiev,

Merkulova,

Teterin

et al. 2024

Rus. J. Evid.-Bas. Gastro.

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Safety and Efficacy of Using Stapler Device for Wide Cystic Duct Ligation in Acute Setting of Laparoscopic Cholecystectomy

Alyami,

Alotaibi,

Alhoumaily

et al. 2024

Preprint

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Introduction: This research explores the challenges posed by variations in cystic duct anatomy during laparoscopic cholecystectomy and the potential use of stapler devices to address such complexities. It aims to assess the safety and efficacy of stapler devices, particularly in cases involving short, and wide cystic duct. Methodology: The study, conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia, between 2021 and 2023. The study design involved a retrospective cohort approach, and the sample size encompassed all cases meeting the inclusion criteria during the study period. Data was analyzed using SPSS program. Results The study involving 568 patients, with the predominant technique for ligation being clipping (89.3%). The primary indication for using the Endo GIA stapler was a wide cystic duct (6.2%). Analysis revealed a significant association between stapler device use and hypertension (p = 0.042), diabetes (p = 0.001), CKD (p = 0.011), and obstructive jaundice (p = 0.006). Multivariate regression demonstrated that older patients were 2.1 times more likely to use stapler devices (AOR = 2.125; p = 0.039), while those with obstructive jaundice had a 2.2 times higher likelihood (AOR = 2.168; p = 0.049). Discussion Throughout the years, metal clips have shown the best prognosis compared to any other method for securing the cystic duct during closure in laparoscopic cholecystectomy. However, to avoid incomplete sealing of wide, short, or inflamed ducts, other instruments have emerged as possible alternatives for such conditions. Conclusion Use of Endo-GIA is a safe and effective method for patients with wide, short cystic duct. Selective usage of endo-GIA is considered cost effective and may add a positive impact in decreasing post operative biliary leak.

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High rate of stone-related complications after stapling the cystic duct during laparoscopic cholecystectomy—an underrecognized risk

Cited by 3 publications

References 31 publications

Safety and efficacy of using stapler device for wide cystic duct ligation in acute setting of laparoscopic cholecystectomy

Safety and efficacy of using stapler device for wide cystic duct ligation in acute setting of laparoscopic cholecystectomy

Intraoperative diagnosis of choledocholithiasis by endoscopic ultrasound

Safety and Efficacy of Using Stapler Device for Wide Cystic Duct Ligation in Acute Setting of Laparoscopic Cholecystectomy

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