Laparoscopic management of common bile duct stones

Ebner, S.; Rechner, J.; Beller, S.; Erhart, K.; Riegler, F. M.; Szinicz, G.

doi:10.1007/s00464-003-9029-5

Cited by 39 publications

(24 citation statements)

References 29 publications

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“…Published reports on the laparoscopic treatment of choledocholithiasis include both cohort studies and individual series [167][168][169][170][171][172][173][174][175][176]. Switching to open surgery occurred in 1.4-13% of procedures [167][168][169][170][171][172][173][174][175][176], and transcystic stone removal was performed more frequently than choledochotomy, with the former being performed in 60-70% of cases [167][168][169][170][171][172][173][174][175][176]. All of these reports found that laparoscopic one-stage removal of common bile duct stones is noninferior to two-stage removal using a peroral endoscope and that laparoscopic surgery can be performed in most cases of choledocholithiasis.…”

Section: Commentarymentioning

confidence: 99%

Evidence-based clinical practice guidelines for cholelithiasis 2016

Tazuma

Unno²,

Igarashi³

et al. 2016

J Gastroenterol

213

178

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Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories-epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications-were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This article preferentially describes the clinical management of cholelithiasis and its complications. Following description of the diagnosis performed stepwise through imaging modalities, treatments of cholecystolithiasis, choledocholithiasis, and hepatolithiasis are introduced along with a flowchart. Since there have been remarkable improvements in endoscopic treatments and surgical techniques, the guidelines ensure flexibility in choices according to the actual clinical environment. The revised clinical practice guidelines are appropriate for use by clinicians in their daily practice.

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Section: Commentarymentioning

confidence: 99%

Evidence-based clinical practice guidelines for cholelithiasis 2016

Tazuma

Unno²,

Igarashi³

et al. 2016

J Gastroenterol

213

178

View full text Add to dashboard Cite

show abstract

“…Unter Einhaltung dieser Vorgaben beträgt die perioperative Morbidität für die laparoskopische Choledochusrevision zwischen 3-20%, die Mortalität bis zu 1,7%. [25]. Voraussetzung für den anschließenden sicheren Verschluss der Choledochotomie ist die diffizile Beherrschung 7 laparoskopischer Verschluss-und Knotentechniken.…”

Section: Laparoskopische Choledochusrevisionunclassified

Choledocholithiasis

Förster

Klar²

2008

Chirurg

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The best predictors for the presence of common bile duct stones (CBDS) are cholangitis, jaundice, and direct visualization of stones with ultrasound. In the setting of high suspicion of choledocholithiasis, endoscopic retrograde cholangiography (ERC) is indicated because when CBDS are identified, it allows immediate therapy in the same sitting. If there is a moderate probability of choledocholithiasis, endosonography or magnetic resonance cholangiopancreatography are the first-line options. In patients with gallbladder stones and CBDS, preoperative ERC with or without endoscopic sphincterotomy (ES) is widely recommended as a standard approach. The interval between that and laparoscopic cholecystectomy (LC) should be at least 24 h (<6 weeks) to exclude possible complications due to the ERC/ES. In the setting of open cholecystectomy, open bile duct surgery is significantly superior to ERC with sphincterotomy in achieving common bile duct clearance and is the method of choice. Only in centres with advanced laparoscopic expertise is the laparoscopic removal of CBDS an equivalent treatment option.

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“…Die aktuelle Entwicklung weist international allerdings in eine andere Richtung. In der Literatur wird zunehmend über große Serien von laparoskopischen Choledochusrevisionen berichtet [7,8,21,28,38].…”

Section: Introductionunclassified

“…Falls dies der Fall ist, kann die Choledochotomie mit gleicher Sicherheit wie bei der offenen Revision verschlossen werden. In erfahrenen Zentren kann mit dieser Technik bei 90-95% der Patienten auf laparoskopischem Wege eine Steinfreiheit des Gallengangssystems erreicht werden[8,21,28]. Dies entspricht den Zahlen, die früher bei der offenen Gallengangsrevision berichtet wurden.…”

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Cholelithiasis: Therapeutisches Splitting als Standard?

Hopt

Adam²

2006

Chirurg

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At the moment, therapeutic splitting is still regarded by the vast majority of surgeons as the gold standard for stones in the common bile duct. Endoscopic clearance of the duct certainly is much less invasive than open exploration. However, this does not apply when compared with laparoscopic stone removal. Both are equivalent in respect to stone clearance rates, but the laparoscopic techniques protect patients from the long-term sequelae of endoscopic papillotomy. This can be important particularly for younger patients. Laparoscopic bile duct exploration is cost-effective and safe. Special experience in laparoscopic surgical techniques, however, is mandatory. Thus, surgeons should intensify their training in laparoscopic bile duct exploration in order to increase the acceptance of these techniques.

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Laparoscopic management of common bile duct stones

Abstract: When correct indications and surgical expertise are observed, simultaneous laparoscopic management of common bile duct stones represents a safe and minimally invasive alternative to a two-procedure approach.

Cited by 39 publications

References 29 publications

Evidence-based clinical practice guidelines for cholelithiasis 2016

Evidence-based clinical practice guidelines for cholelithiasis 2016

Choledocholithiasis

Cholelithiasis: Therapeutisches Splitting als Standard?

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