Management of bile duct stones at cholecystectomy: an Australian single-centre experience over 2 years

Choi, Kihoon; Amarasena, Tehan; Hughes, Andrew; Shaw, Ian; Iswariah, Harish; Tam, Diana; Franz, Robert; Chandrasegaram, Manju D.

doi:10.1007/s00464-020-07495-7

Cited by 4 publications

(2 citation statements)

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“…Although LCBDE is considered a safe and effective procedure for patients with ERCP failure, it is also an effective treatment for CBD stone suspected at cholecystectomy. However, CBD stone may still recur even after LCBDE [1,[16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…An endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) before or after cholecystectomy as a two-stage procedure has been widely accepted as an effective and minimally invasive treatment for CBD stone. Another approach for the management of choledocholithiasis is a one-stage procedure involving laparoscopic CBD exploration (LCBDE) and laparoscopic cholecystectomy (LC) [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors of recurrence following common bile duct exploration for choledocholithiasis

Choi

Min

Kook

et al. 2021

J Minim Invasive Surg

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Purpose: The purpose of this study was to investigate the recurrence factors of choledocholithiasis after common bile duct (CBD) exploration.Methods: From January 2000 to December 2018, we retrospectively reviewed 253 patients who underwent CBD exploration surgery. We excluded 100 cases who had residual stone, combined major surgery, or follow-up loss after surgery. Total of 153 patients were included, and we investigated the recurrence factors of choledocholithiasis. Various variables such as patients' demographics, gallstones, preoperative endoscopic treatment, and laboratory data were analyzed to find factors related to recurrent choledocholithiasis. Results:The median follow-up period was 20.6 months (range 4.7-219 months), and 27 patients (17.6%) had experienced recurrent choledocholithiasis. Univariate analysis showed that the following variables were associated with recurrence of choledocholithiasis; preoperative leukocytosis (white blood cell ≥ 11,000/µL), open procedure, T tube insertion, long hospital duration, and long operation time. Logistic regression multivariate analysis identified preoperative leukocytosis (odds ratio [OR], 3.43; 95% confidence interval [CI], 1.21-9.73; p = 0.021), open procedure (OR, 5.54; 95% CI, 4.73-6.35; p = 0.037), and T-tube insertion (OR, 2.82; 95% CI, 1.04-7.65; p = 0.042) as independent predictors of recurrent choledocholithiasis. Conclusion:Because of delayed recurrence of choledocholithiasis, it is recommended to continue follow-up of patients after CBD exploration surgery. Laparoscopic surgery was observed to be associated with a reduction in recurrence. The preoperative leukocytosis and clinical conditions in which open surgery is performed could be associated with recurrence of choledocholithiasis. However, further study is necessary to validate the result.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%