Laparoscopic common bile duct exploration following prior gastrectomy: surgical safety and feasibility

Park, Sun Min; Paik, Kwang Yeol

doi:10.1007/s00423-023-03029-6

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Laparoscopic common bile duct exploration (LCBDE) has recently been reported to be safe and effective in patients with previous gastrectomy patients under the advancement of technology. [8–12] After gastrectomy, adhesions around the hepatoduodenal ligament are prone to occur frequently, increasing the risk of intraoperative bleeding and vascular or biliary tract injury. It is worth noting that the above adhesions were different from those after general abdominal surgery.…”

Section: Introductionmentioning

confidence: 99%

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The feasibility and safety of laparoscopic transcystic common bile duct exploration after prior gastrectomy

Huang,

Chen,

et al. 2024

Medicine

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The increased incidence of gallstones can be linked to previous gastrectomy (PG). However, the success rate of endoscopic retrograde cholangiopan-creatography after gastrectomy has significantly reduced. In such cases, laparoscopic transcystic common bile duct exploration (LTCBDE) may be an alternative. In this study, LTCBDE was evaluated for its safety and feasibility in patients with PG. We retrospectively evaluated 300 patients who underwent LTCBDE between January 2015 and June 2023. The subjects were divided into 2 groups according to their PG status: PG group and No-PG group. The perioperative data from the 2 groups were compared. The operation time in the PG group was longer than that in the No-PG group (184.69 ± 20.28 minutes vs 152.19 ± 26.37 minutes, P < .01). There was no significant difference in intraoperative blood loss (61.19 ± 41.65 mL vs 50.83 ± 30.47 mL, P = .087), postoperative hospital stay (6.36 ± 1.94 days vs 5.94 ± 1.36 days, P = .125), total complication rate (18.6 % vs 14.1 %, P = .382), stone clearance rate (93.2 % vs 96.3 %, P = .303), stone recurrence rate (3.4 % vs 1.7 %, P = .395), and conversion rate (6.8 % vs 7.0 %, P = .941) between the 2 groups. No deaths occurred in either groups. A history of gastrectomy may not affect the feasibility and safety of LTCBDE, because its perioperative results are comparable to those of patients with a history of No-gastrectomy.

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Section: Introductionmentioning

confidence: 99%

“…Previous experience has shown that LCBDE is suitable for patients with Billroth II or Roux-en-Y esophagojejunostomy history. [12,13] However, LCBBE is prone to postoperative complications such as bile leakage, water and electrolyte disorders, bile duct stenosis, and T-tube slippage. [14–16]…”

Section: Introductionmentioning

confidence: 99%

The feasibility and safety of laparoscopic transcystic common bile duct exploration after prior gastrectomy

Huang,

Chen,

et al. 2024

Medicine

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Laparoscopic transcystic common bile duct exploration following prior gastrectomy: the safety and feasibility Running head: Laparoscopic transcystic common bile duct exploration

Huang,

Wei,

Chen

et al. 2024

Preprint

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Background Previous gastrectomy (PG) can lead to an increased incidence of gallstones. The purpose of this study was to evaluate the safety and feasibility of laparoscopic transcystic common bile duct exploration (LTCBDE) for PG patients. Methods A total of 300 patients who received LTCBDE in the same center from January 2015 to June 2023 were retrospectively evaluated. According to the PG status, the patients were divided into two groups: PG group and No-PG group. The characteristics of the disease, cystic duct incision method, surgical results and complications were analyzed. Results LTCBDE was performed in 300 patients. Among them, 59 patients had a history of gastrectomy. In general, the success rate of LTCBDE was 93%, 1 (0.3%) was converted to laparotomy, 21 (7%) underwent laparoscopic common bile duct exploration + T-tube drainage, and 3 (1%) did not find stones during intraoperative exploration. Complications occurred in 45 (15%). There was no significant difference in postoperative complications between PG group and No-PG group. In multivariate analysis, Calot 's triangle adhesion (hazard ratio (HR): 0.383, 95% confidence interval (CI): 0.185–0.792, P = 0.010) and anatomical variation of bile duct (HR: 0.349, 95% CI: 0.162–0.749, P = 0.007) were risk factors for overall complications. Conclusions LTCBDE is safe and feasible for PG patients. With the continuous advancement of technology, LTCBDE has been effectively promoted and applied.

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Laparoscopic common bile duct exploration following prior gastrectomy: surgical safety and feasibility

Cited by 2 publications

References 12 publications

The feasibility and safety of laparoscopic transcystic common bile duct exploration after prior gastrectomy

The feasibility and safety of laparoscopic transcystic common bile duct exploration after prior gastrectomy

Laparoscopic transcystic common bile duct exploration following prior gastrectomy: the safety and feasibility Running head: Laparoscopic transcystic common bile duct exploration

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