Identification of bile duct stones in patients undergoing laparoscopic cholecystectomy

Abstract

To identify patients with common bile duct stones, all patients considered for laparoscopic cholecystectomy in this unit undergo intravenous cholangiography (IVC) with tomography and, more recently, operative cholangiography. To date 100 consecutive patients with symptomatic gallstones have undergone laparoscopic cholecystectomy with no specific exclusion criteria. Eight patients of 100 were found to have duct stones on IVC with one false-positive. These IVC data were compared with data from 52 patients who also had operative cholangiograms performed. One stone was detected on operative cholangiography that was not identified on IVC. No additional information was gained from operative cholangiography. These data suggest that preoperative IVC is adequate for the detection of duct stones in patients considered for laparoscopic cholecystectomy.

Timing of cholecystectomy after endoscopic sphincterotomy for common bile duct stones

“…Of the patients presenting with cholecystolithiasis, 4% to 15% have concomitant common bile duct (CBD) stones [1][2][3]. The current standard of treatment for symptomatic…”

“…These recurrent complications were associated with a significantly longer hospital stay. Cholecystectomy within 1 week after ES may prevent recurrent biliary complications in the majority of cases and reduce the postoperative hospital stay.Keywords Biliary complications Á Cholecystectomy Á Common bile duct Á Conversion rate Á Endoscopic sphincterotomyOf the patients presenting with cholecystolithiasis, 4% to 15% have concomitant common bile duct (CBD) stones [1][2][3]. The current standard of treatment for symptomatic…”

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

“…For low-risk patients the one-step laparoscopic treatment has progressively been incorporated into clinical practice. Furthermore, the use of biliary endoprosthesis after bile duct laparoscopic exploration may be a safe and effective alternative as compared with the implantation of a Kehr tube (Low quality evidence) (Smith, 1997;Joyce, 1991;Prat, 1996;Costi, 2007;Trondsen, 1998;Liu, 2001;Cuschieri, 1999;Wei, 2003;Gurusamy, 2007;Griniatsos, 2005;KimK, 2004;Lien, 2005;Decker, 2003;Fanelli, 2001).…”

“…CBDL treatment has mainly been undertaken by endoscopy prior to LC. This strategy appears to resolve CBDL in most cases but is likely to find no evidence of the presence of a stone in 20-60% of patients and is associated with a considerable morbidity risk (Paganini, 2007;Smith, 1997;Joyce, 1991;Prat, 1996;Costi, 2007;Trondsen, 1998).…”

Assessment of Indicators for Predicting Choledocholithiasis Before Laparoscopic Cholecystectomy

“…5,[15][16][17] There has been renewed interest in intravenous cholangiography for detection of bile duct stones as newer contrast materials which are less allergenic and provide adequate imaging become available. 18 Magnetic resonance cholangiography is another new modality being used in the assessment of biliary tract disease. Preliminary results of MRCP are similar to those of more invasive ERCP, 19 but this imaging is not yet widely available.…”