Laparoscopic common bile duct exploration for choledocholithiasis: Theodor Bilharz Research Institute preliminary experience

Salama, Asaad F; Helmy, Ahmed; Hedaya, Mohamed S; Rizk, Hisham; Esmat, Emad

doi:10.4103/1110-1121.176812

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…Hajibandeh et al 32 reported similar conclusions from 30 studies. Salama et al 33 highlighted the shorter hospital stay after TCE (1–3 days vs 2–7 days). These results concur with our findings of TCE outcomes similar to LC alone.…”

Section: Discussionmentioning

confidence: 99%

Conventional Surgical Management of Bile Duct Stones

Nassar

Katbeh

et al. 2020

Annals of Surgery

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Objective: The primary aim of this study was to describe the service model of one-session management, with a limited role for preoperative endoscopic clearance. The secondary aim was to review the outcomes and long term follow up in comparison to available studies on LCBDE. Background: The laparoscopic era brought about a decline in the conventional surgical management of common bile duct stones. Preoperative endoscopic removal became the primary method of managing choledocholithiasis. Although LCBDE deals with gallstones and ductal stones in onw session, the limited availability of such an advanced procedure perpetuated the reliance on the endoscopic approach. Methods: Prospective data was entered into a single surgeon's database containing 5739 laparoscopic cholecystectomy over 28 years and analyzed. Results: One thousand eighteen consecutive LCBDE were included (23% of the series). Intraoperative cholangiography was performed in 1292 (98.0%). The median age was 60 years, male to female ratio 1:2 and 75% were emergency admissions. Most patients (43.4%) presented with jaundice. 66% had transcystic explorations and one third through a choledochotomy with 2.1% retained stones, 1.2% conversion, 18.7% morbidity, and 0.2% mortality. Postoperative ERCPs were needed in 3.1%. Recurrent stones occurred in 3%. Conclusions: One stage LCBDE is a safe and cost-effective treatment where the expertise and equipment are available. Endoscopic treatment has a role for specific indications but remains the first-line treatment in most units. This study demonstrates that establishing specialist services through training and logistic support can optimize the outcomes of managing common bile duct stones.

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Section: Discussionmentioning

confidence: 99%

Conventional Surgical Management of Bile Duct Stones

Nassar

Katbeh

et al. 2020

Annals of Surgery

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“…13,14 With the advancement in laparoscopic equipment, skills and experience, laparoscopic approach have become the gold standard for management of the CBD stones over the past few decades. 15,16 Although it is safe and highly effective method in the management of CBDS, It requires surgeons with advanced laparoscopic experience and skills, advanced laparoscopic techniques and equipment. 17,18 Laparoscopic treatment for CBDS is a safe, efficient, cost-effective with a high success rate of stone clearance from 84 to 97%, with a morbidity rate 4-16%, and a mortality rate 0-0.8%.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of laparoscopic versus open surgery in management of common bile duct stones: experience at the Sohag University Hospital, Egypt

Helmy

Ahmed

2018

Int Surg J

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Background: Management of common bile duct (CBD) stones includes removal of the gallbladder and clearance of the ductal system which can be achieved through different approaches; endoscopic, laparoscopic or surgical. Objective of this study is to assess the safety, efficacy, technical feasibility and surgical outcomes of laparoscopic common bile duct exploration (LCBDE) versus open surgery in the treatment of patients with cholidocholithiasis.Methods: From June 2015 to December 2017, 120 patients with CBD stones were prospectively treated at Sohag University Hospital, Upper Egypt. Patients were divided into two groups: the first one treated by LCBDE (60 patients), while the other group treated by open surgery (60 patients).Results: The ages of our patients were ranged from 20 to 80 (mean = 40) years, with a female predominance (female/male = 74/46). Patients in the first group were treated by laparoscopic approaches: transcystic approaches in four patients and transcholedochotomy approaches in 56 patients. Choledochoscop was routinely used to detect, extract the stones, in addition to assessment of CBD clearance. The conversion rate was done in two cases. The operative time was 120 (90-220) min, the clearance of CBD stones was achieved in 98.4% of cases (one case of missed stones). Hospital stay was 3 (2-4) days, with no mortality, morbidity rate was 5% including bile leak, and missed stone. The operative time in the second group was 100 (80-180) min, the clearance of CBD stones was achieved in 96.6% of cases (two cases of missed stones). Hospital stay was 8 (5-12) days, with no mortality; the morbidity rate was 15% in the form of wound infection, bile leak, missed stone and ileus.Conclusions: Management of cholidocholithiasis by laparoscopic approach is feasible, effective and safe procedure with good outcome and high success rate.

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Laparoscopic common bile duct exploration for choledocholithiasis: Theodor Bilharz Research Institute preliminary experience

Cited by 2 publications

References 3 publications

Conventional Surgical Management of Bile Duct Stones

Conventional Surgical Management of Bile Duct Stones

Safety and efficacy of laparoscopic versus open surgery in management of common bile duct stones: experience at the Sohag University Hospital, Egypt

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