Intraoperative cholangiography 2020: Quo vadis? A systematic review of the literature

Γεωργίου, Κωνσταντίνος; Sandblom, Gabriel; Alexakis, Nicholas; Enochsson, Lars

doi:10.1016/j.hbpd.2022.01.002

Cited by 8 publications

(5 citation statements)

References 42 publications

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“…IC reduces the morbidity associated with biliary tract injury, provides a clear depiction of the biliary anatomy, and provides critical insight into safety by helping surgeons identify the cystic duct before division. Additionally, it offers intraoperative information for identifying stones in the common bile duct, enabling their removal during surgery and reducing subsequent episodes of cholangitis and pancreatitis [34].…”

Section: Discussionmentioning

confidence: 99%

The Frequency of Anatomical Variants of the Bile Ducts: A Review Based on a Single Classification as Support for Cholangiographic Examinations

Olmedo,

Dos Santos,

Junior

2024

Cureus

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Complications arising from hepatobiliary surgery can have adverse effects on both the quality of life and the survival of patients. Magnetic resonance cholangiography (MRC) techniques are highly effective at revealing anatomical variants of the bile ducts and thus play a vital role in minimizing the occurrence of complications.The aims of this review are threefold: to ascertain the classifications utilized for categorizing anatomical variants of the bile ducts, to present the reported results on the prevalence of these anatomical variants, and to explore the diagnostic modalities employed to visualize these anatomical variants and associated complications during surgical procedures.A review of the literature was carried out using the Cochrane Library database and the PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), and Google Scholar platforms. We conducted a comprehensive review of relevant studies to categorize the different anatomical variants according to the Huang classification.According to the Huang classification, our study showed type A1, 60.44%; type A2, 11.76%; type A3, 11.73%; type A4, 5.47%; type A5, 0.26%; and type B, which was identified in insignificant numbers (0.16%) or does not appear; additionally, variants that do not fit into the Huang classification have also been identified (10.18%).The Huang classification serves as an invaluable presurgical guide, aiding in the strategic planning of biliary interventions and effectively reducing the risk of iatrogenic complications, morbidity, mortality, and postoperative length of stay. MRC is still considered the noninvasive gold standard method for evaluating the bile ducts and their anatomical variations.

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Section: Discussionmentioning

confidence: 99%

The Frequency of Anatomical Variants of the Bile Ducts: A Review Based on a Single Classification as Support for Cholangiographic Examinations

Olmedo,

Dos Santos,

Junior

2024

Cureus

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“…Этот важный раздел эндоскопической хирургии необходим хирургам для безопасного выполнения холецистэктомии, интраоперационной диагностики и лечения камней в желчных протоках [13,33]. В недавнем крупном обсервационном исследовании с минимизированным риском предвзятости отбора для оценки эффективности интраоперационной ЭРХПГ доказано, что процедура снижает риски послеоперационного панкреатита и выявления резидуальных камней общего желчного протока [18]. В краткосрочной перспективе ЭРХПГ увеличивает стоимость операции, однако это компенсируется снижением затрат в последующем.…”

Section: результатыunclassified

“…С течением времени количество чисто диагностических ЭРХПГ снижается, а количество лечебных интервенционных случаев с высоким риском и сложностью нарастает [18,20,33]. В связи со своим инвазивным характером ЭРХПГ сопровождается неизбежными осложнениями, которые варьируются от тривиальных инцидентов до серьезных, угрожающих жизни ситуаций, требующих дополнительных вмешательств и расхода лекарственных средств, вызывают удлинение сроков стационарного лечения.…”

Section: результатыunclassified

“…Особую актуальность приобретают эндоскопические вмешательства: ЭРХПГ, папиллосфинктеротомия, транспапиллярное эндопротезирование общего желчного протока, эндоскопическое рассечение рубцовосуженных билиодигестивных анастомозов. Высокая диагностическая ценность и терапевтическая эффективность транспапиллярных вмешательств при осложненных формах ЖКБ достигает 82-94% и позволяет этим методам занять ведущее место в лечебно-диагностическом комплексе [12,18,20,24]. Сочетание ЭРХПГ при камнях общего желчного протока с ЭДЖП за 1 сеанс может стать нехирургической стратегией комплексного лечения ЖКБ в показанных случаях у отдельных пациентов [17,31].…”

Section: результатыunclassified

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The Role of Diapeutical Methods and X-Ray Surgery in the Treatment of Complicated Forms of Cholelithiasis

Нурмурзаев,

Жураев,

Хамидов

et al. 2023

Хирургия. Восточная Европа

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Введение. Лечение осложнений желчнокаменной болезни представляет собой актуальную проблему современной билиарной хирургии вследствие широкого распространения патологии и возможных тяжелых исходов для пациентов. Цель. Анализ возможностей применения эндоскопических транскутанных диапевтичесĸих и рентгенохирургических методов в лечении данной патологии в современных условиях. Материалы и методы. Для достижения указанной цели был проведен анализ научных публикаций в рецензируемых профильных медицинских изданиях по применению малоинвазивных методов лечения под ультразвуковым и рентгенологическим контролем, а также интраоперационных эндоскопических методик при осложненном течении холедохолитиаза. Поиск проводился в базах данных inLibrary, Scopus, PubMed и Google Scholar, отбирались аналитические, ретроспективные, проспективные исследования, работы смешанного дизайна, систематические обзоры и национальные исследования за 2018–2023 гг. Результаты. Рассмотрены преимущества, возможные сложности и меры их преодоления при применении мини-инвазивных чрескожных и эндоскопических методов в лечении осложнений билиарного литиаза. Проанализированы возможные хирургические тактики при лечении осложнений желчнокаменной болезни, слабые и сильные стороны такого выбора, основные рекомендации по оптимизации лечения. Сделаны выводы о высокой эффективности сочетанной ультразвуковой, рентгеновской и эндоскопической визуализации. Предложены меры по обеспечению безопасного широкого применения диапевтичесĸих методов в специализированных медицинских центрах. Заключение. Рациональное применение спектра рассмотренных методик позволит существенно улучшить результаты лечения пациентов, снизить летальность, уменьшить время стационарного лечения и реабилитации этих пациентов, а также снизить суммарные расходы на лечение. Introduction. The treatment of complications of cholelithiasis is a pressing issue in modern biliary surgery due to the wide spread of the pathology and possible severe outcomes for patients. Purpose. Analysis of the possibilities of using endoscopic transcutaneous diapeutical and X-ray surgical methods in the treatment of this pathology in modern conditions. Materialsandmethods.Toachievethestatedpurpose, ananalysisofscientificpublications in peer-reviewed specialized medical journals on the application of minimally invasive treatment methods under ultrasound and radiographic guidance, as well as intraoperative endoscopic techniques in complicated choledocholithiasis, was conducted. The search was conducted in the inLibrary, Scopus, PubMed, and Google Scholar databases, and analytical, retrospective, prospective studies, mixed-design studies, systematic reviews, and national studies from 2018–2023 were selected. Results. The advantages, potential challenges, and measures to overcome them in the application of minimally invasive percutaneous and endoscopic methods for treating complications of biliary lithiasis were examined. Possible surgical tactics in the treatment of complications of gallstone disease, their strengths and weaknesses, and key recommendations for treatment optimization were analyzed. Conclusions were drawn regarding the high effectiveness of combined ultrasound, radiographic, and endoscopic visualization. Measures were proposed to ensure the safe and wide application of diathermic methods in specialized medical centers. Conclusion. It is concluded that the rational application of the spectrum of the discussed techniques will significantly improve treatment outcomes, reduce mortality, decrease the duration of hospitalization and rehabilitation of these patients, as well as reduce the overall treatment costs.

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“…However, the latter is the preferred method in clinical practice in symptomatic cases with transient obstructive jaundice or elevated liver function tests and previous episodes of acute pancreatitis[ 8 ]. A debate still exists about the routine or selective use of intraoperative cholangiography[ 9 ], but it seems more reasonable in the era of MRCP availability based on well-defined indications[ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Current management of concomitant cholelithiasis and common bile duct stones

Pavlidis¹,

Pavlidis²

2023

World J Gastrointest Surg

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The management policy of concomitant cholelithiasis and choledocholithiasis is based on a one- or two-stage procedure. It basically includes either laparoscopic cholecystectomy (LC) with laparoscopic common bile duct (CBD) exploration (LCBDE) in the same operation or LC with preoperative, postoperative and even intraoperative endoscopic retrograde cholangiopancreatography-endoscopic sphincterotomy (ERCP-ES) for stone clearance. The most frequently used worldwide option is preoperative ERCP-ES and stone removal followed by LC, preferably on the next day. In cases where preoperative ERCP-ES is not feasible, the proposed alternative of intraoperative rendezvous ERCP-ES simultaneously with LC has been advocated. The intraoperative extraction of CBD stones is superior to postoperative rendezvous ERCP-ES. However, there is no consensus on the superiority of laparoendoscopic rendezvous. This is equivalent to a traditional two-stage procedure. Endoscopic papillary large balloon dilation reduces recurrence. LCBDE and intraoperative ERCP have similar good outcomes. The risk of recurrence after ERCP-ES is greater than that after LCBDE. Laparoscopic ultrasonography may delineate the anatomy and detect CBD stones. The majority of surgeons prefer the transcductal instead of the transcystic approach for CBDE with or without T-tube drainage, but the transcystic approach must be used where possible. LCBDE is a safe and effective choice when performed by an experienced surgeon. However, the requirement of specific equipment and advanced training are drawbacks. The percutaneous approach is an alternative when ERCP fails. Surgical or endoscopic reintervention for retained stones may be needed. For asymptomatic CBD stones, ERCP clearance is the first-choice method. Both one-stage and two-stage management are acceptable and can ensure improved quality of life.

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Intraoperative cholangiography 2020: Quo vadis? A systematic review of the literature

Cited by 8 publications

References 42 publications

The Frequency of Anatomical Variants of the Bile Ducts: A Review Based on a Single Classification as Support for Cholangiographic Examinations

The Frequency of Anatomical Variants of the Bile Ducts: A Review Based on a Single Classification as Support for Cholangiographic Examinations

The Role of Diapeutical Methods and X-Ray Surgery in the Treatment of Complicated Forms of Cholelithiasis

Current management of concomitant cholelithiasis and common bile duct stones

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