Outcomes of Laparoscopic vs Open Common Bile Duct Exploration: Analysis of the NSQIP Database

Halawani, Hamzeh M.; Tamim, Hani; Khalifeh, Farah; Mailhac, Aurélie; Taher, Alì; Hoballah, Jamal J.; Jamali, Faek R.

doi:10.1016/j.jamcollsurg.2017.01.062

Cited by 25 publications

(24 citation statements)

References 19 publications

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“…[9] Though the supporters of open method are few, this method is being justified in some countries due to its low costs and when laparoscopic and endoscopic approaches failure. [6,7] After open surgeries carried out in our study, common complications (33.3%), severe complications (24.3%), mortality (3.8%) and hospital stay (8.2±2.7 days) were found to be significantly higher than other methods.…”

Section: Discussionmentioning

confidence: 62%

“…Classical open method that was extensively used before, is currently applied in 5-52% cases, and though it is cheap and efficient method, the complication rate is high. [6,7] During 1990s, with the extensive application of laparoscopic cholecystectomy, two-stage endoscopic-laparoscopic method has emerged (pre-or postoperative ERCP and laparoscopic cholecystectomy), and is considered the most common approach at present. [8,9] Two-stage endoscopic-laparoscopic approach has certain disadvantages such as complication (pancreatitis, duodenal injury), twice exposure to surgery, and high costs.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of open, laparo-endoscopic and one-stage laparoscopic approaches for treatment of gallbladder and common bile duct stones

Bayramov¹

2017

Laparosc Endosc Surg Sci

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Comparison of open, laparo-endoscopic and one-stage laparoscopic approaches for treatment of gallbladder and common bile duct stones

Bayramov¹

2017

Laparosc Endosc Surg Sci

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“…Rafailidis et al, Grubnik et al and Halawani et al, also showed the higher complication rate of the open approach vs. LCBDE. 6,24,31 Although OCBDE is a safe and effective approach for the treatment of CBDS, nowadays with advancement in the equipment and laparoscopic skills, LCBDE can be performed with high efficiency, safety, low morbidity and mortality. 6,31 However, open surgery is still the standard for removal of the bile duct stones.…”

Section: Discussionmentioning

confidence: 99%

“…6,24,31 Although OCBDE is a safe and effective approach for the treatment of CBDS, nowadays with advancement in the equipment and laparoscopic skills, LCBDE can be performed with high efficiency, safety, low morbidity and mortality. 6,31 However, open surgery is still the standard for removal of the bile duct stones. If the surgical team has a lack of the laparoscopic experience, or highly expert endoscopists are not available, an open surgery should be employed.…”

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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“…No intervention was needed as patients improved. This complication rate, although not alarming, can be further reduced by opting for laparoscopic procedures that have fewer side effects [ 1 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Choledocholithiasis: Treatment Options in a Tertiary Care Setup in Pakistan

Ghazanfor¹,

Liaqat²,

Changeez³

et al. 2017

Cureus

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IntroductionAmong patients with cholelithiasis, choledocholithiasis may also be present in about 18% of cases. They can be treated through various endoscopic, laparoscopic, and open surgical procedures.ObjectiveThe objective of this study was to determine the outcome of patients with choledocholithiasis being treated in our setup.MethodsThis descriptive case series was conducted at Holy Family Hospital, Rawalpindi, Pakistan over two years from January 2015 to December 2016. All patients with choledocholithiasis admitted to Surgical Unit 1 were included in this study. All patients underwent elective endoscopic retrograde cholangiopancreatography (ERCP). In patients with successful ERCP, laparoscopic or open cholecystectomy was performed at a later date. In patients in whom ERCP failed, open surgical clearance of the common bile duct (CBD), along with cholecystectomy, was done.ResultsA total of 200 cases of choledocholithiasis were admitted during the study period. Most of the participants (73%) in this study were female. Liver function tests were found to be deranged in 88 patients (44%) and normal in 112 patients (56%). At presentation, 3.5% (n=7) had concomitant acute biliary pancreatitis and 8% (n=16) had cholangitis. Successful ERCP followed by cholecystectomy was performed in 88.5% of cases. On the other hand, 11.5% (n=23) patients had failed ERCP due to impacted stones. They underwent open surgical procedures, i.e. 43.48% (n=10) had choledochotomies, 47.82% (n=11) had choledochoduodenostomies and 8.69% (n=2) had hepaticojejunostomies. No postoperative mortality was observed. However, anastomotic leaking occurred in 8.69% cases (n=2).ConclusionA two-staged procedure consisting of ERCP, followed by laparoscopic cholecystectomy, should be the first line of treatment for common bile duct (CBD) stones. In cases where ERCP fails, open surgical procedures still remain a relevant and a definitive option in resource-constrained setups.

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Outcomes of Laparoscopic vs Open Common Bile Duct Exploration: Analysis of the NSQIP Database

Cited by 25 publications

References 19 publications

Comparison of open, laparo-endoscopic and one-stage laparoscopic approaches for treatment of gallbladder and common bile duct stones

Comparison of open, laparo-endoscopic and one-stage laparoscopic approaches for treatment of gallbladder and common 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

Choledocholithiasis: Treatment Options in a Tertiary Care Setup in Pakistan

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