Management of Common Bile Duct Stones

Hungness, Eric S.; Soper, Nathaniel J.

doi:10.1016/j.gassur.2005.08.015

Cited by 88 publications

(60 citation statements)

References 45 publications

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“…Choledocholithiasis develops in about 5-15 % of patients with gallbladder stones and is the second most frequent complication of cholecystolithiasis [4]. Especially, primary CBD Fig.…”

Section: Discussionmentioning

confidence: 99%

Primary Closure Following Laparoscopic Common Bile Duct Reexploration for the Patients Who Underwent Prior Biliary Operation

et al. 2016

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To assess feasibility of primary closure following laparoscopic common bile duct reexploration for the patients who underwent prior biliary operation, we retrospectively studied 50 patients with recurrent or residual common bile duct (CBD) stones who underwent laparoscopic biliary reoperation between June 2008 and June 2013. Endoscopic sphincterotomy (EST) was treated for all these patients and validated failed. They were divided into two groups. Primary closure following laparoscopic common bile duct exploration (LCBDE) was performed in 25 cases (group A); LCBDE plus T-tube drainage was performed in others (group B). The items of operation were compared. The duration of the operation in group A was shorter than that in group B (141 ± 85 vs 158 ± 71 min, p < 0.05), as was postoperative hospital stay (16 ± 2.3 vs 23 ± 2.3 h, p < 0.05) and the times of postoperative gastrointestinal function recovery (16 ± 2.3 vs 23 ± 2.3 h, p < 0.05). Just one duodenum was damaged in group B. Postoperative clinically significant bile leakage occurred in two patients in group A and one case in group B. The median follow-up was 18 months. No postoperative pancreatitis, postoperative bleeding, bile peritonitis after T-tube removal, stricture of bile duct, and death occurred in the two groups. Just two cases in group B were verified residual stones after 1 month. Primary closure following laparoscopic common bile duct reexploration for the patients who underwent prior biliary operation appears to be a minimally invasive, safe, feasible, and effective procedure when done by expert laparoscopic surgeons.

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“…Choledocholithiasis develops in about 5-15 % of patients with gallbladder stones and is the second most frequent complication of cholecystolithiasis [4]. Especially, primary CBD Fig.…”

Section: Discussionmentioning

confidence: 99%

Primary Closure Following Laparoscopic Common Bile Duct Reexploration for the Patients Who Underwent Prior Biliary Operation

et al. 2016

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“…Choledocholithiasis, which is the second most common complication of cholecystolithiasis, occurs in 10-20% of the patients with symptomatic gallstones [1,2]. Some stones may pass spontaneously into the duodenum, but others will cause full or partial obstruction of the bile and/or pancreatic duct.…”

Section: Introductionmentioning

confidence: 99%

Primary Closure and Rate of Bile Leak following Laparoscopic Common Bile Duct Exploration via Choledochotomy

et al. 2015

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Background: Choledocholithiasis is traditionally managed by endoscopic retrograde cholangiopancreatography or T-tube insertion following common bile duct exploration. This study examined the efficacy and safety of primary duct closure following laparoscopic common bile duct exploration (LCBDE) via choledochotomy. Methods: Between September 2011 and September 2013, 157 consecutive patients underwent LCBDE via choledochotomy. Results: Of 157 LCBDE procedures, 138 (87.9%) were successfully completed with primary closure of the choledochotomy. Eight patients (5.1%) underwent closure with T-tube drainage after choledochotomy and 11 patients (7.0%) were converted to open surgery. The biliary tree was free of stones at the end of surgery in 154 patients (98.1%). Postoperative bile leak occurred in 6 patients (3.8%). The median follow-up period was 18 (2-33) months, with no evidence of further bile duct stones or bile duct stricture in any patients. Univariable analysis revealed that successful duct clearance (p = 0.010) and diameter of the common bile duct (p < 0.001) were two significant risk factors for bile leak. Conclusions: Primary duct closure following LCBDE is effective and safe for the management of choledocholithiasis. The postoperative bile leak rate may be low in skilled laparoscopic surgeons with a careful selection of patients.

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“…Choledocholithiasis develops in about 5-15% of patients with gallbladder stones and is the second most frequent complication of cholecystolithiasis [1][2][3][4], representing a significant danger to patients because it can result to biliary colic, obstructive jaundice, cholangitis, or pancreatitis [5]. These patients may require surgical intervention to remove stones, such as choledochotomy, in which indications include the history or presence of any of the following: history of elevated liver function tests, history or presence of jaundice, biliary pancreatitis, radiographic evidence of a dilated ductal system, and radiographic visualization of common bile duct stones.…”

Section: Introductionmentioning

confidence: 99%

“…It is performed for the following reasons: (1) post-operative decompression of the CBD if outflow obstruction occurs, (2) post-operative visualization of the CBD by X-ray, and (3) availability of a T-tube to extract CBD stones with a Burhenne steerable catheter [9,10]. However, its usage is not without morbidity and produces complications up to 10% of patients [3,6].…”

Section: Introductionmentioning

confidence: 99%

Primary closure versus T-tube drainage after common bile duct exploration for choledocholithiasis

Zhu

Tao

Zhou

et al. 2010

Langenbecks Arch Surg

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Management of Common Bile Duct Stones

Cited by 88 publications

References 45 publications

Primary Closure Following Laparoscopic Common Bile Duct Reexploration for the Patients Who Underwent Prior Biliary Operation

Primary Closure Following Laparoscopic Common Bile Duct Reexploration for the Patients Who Underwent Prior Biliary Operation

Primary Closure and Rate of Bile Leak following Laparoscopic Common Bile Duct Exploration via Choledochotomy

Primary closure versus T-tube drainage after common bile duct exploration for choledocholithiasis

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