Preoperative versus intraoperative endoscopic sphincterotomy for management of common bile duct stones

Elgeidie, Ahmed; Ebidy, Gamal El; Naeem, Yussef M.

doi:10.1007/s00464-010-1348-8

Cited by 56 publications

(83 citation statements)

References 51 publications

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“…The CBD stone removal was performed after cholecystectomy by turning the patient to prone position as is done normally for routine ERC. We concur with these authors [17] that passing the guide-wire through cystic duct offers no added advantage and the bowel distention resulting from ERC renders the subsequent steps of cholecystectomy cumbersome. In a review of 27 published studies on the rendezvous technique comprising of 795 patients, Greca et al reported a success rate of 92.3 %, morbidity 5.1 % and the mortality rate 0.37 %.…”

Section: Discussionsupporting

confidence: 83%

“…This single-sitting approach was subsequently termed as 'rendezvous' technique [16]. We followed a slightly different technique similar to what has been reported by ElGeidie et al [17]. The CBD stone removal was performed after cholecystectomy by turning the patient to prone position as is done normally for routine ERC.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the logistical issue of co-ordination between two teams did not arise. This advantage has been highlighted by surgeons who are also trained to perform endoscopic clearance [17]. In a meta-analysis, Gurusamy et al reported intraoperative CBD clearance to be as safe and effective as preoperative clearance with an added advantage of shorter hospital stay [18].…”

Section: Discussionmentioning

confidence: 99%

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‘Single-Sitting’ Laparoscopic Cholecystectomy and Endoscopic Removal of Common Bile Duct Stone for Cholelithiasis and Choledocholithiasis: a Feasibility Study

Ibrarullah¹,

Mishra²,

Dash³

et al. 2013

Indian J Surg

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'Single-sitting' laparoscopic cholecystectomy followed by endoscopic common bile duct clearance is emerging as a viable option for management of cholelithiasis and concomitant choledocholithiasis. The only disadvantage of the procedure is logistical since it requires co-ordination between two teams-the surgeons and the endoscopists. This limitation can be overcome in centres where both the procedures are performed by one team. With a considerable experience in endoscopy, we conducted a prospective study in a select group of patients to assess the feasibility of this single-sitting approach. The study included 38 patients with a radiological diagnosis of choledocholithiasis or jaundice at presentation. After laparoscopic cholecystectomy, the patients were turned prone and subjected to endoscopic retrograde cholangiogram, sphincterotomy and extraction of the common bile duct stone. The procedure was successful in 33 (87 %) of patients. The mean procedure time and hospital stay were 2 h, 20 min and 2 days, respectively. None of the patients had any major complications. We conclude that in a select group of patients, single-sitting laparoscopic cholecystectomy followed by endoscopic clearance of the common bile duct stone is safe and effective.Keywords Choledocholithiasis . CBD Stone . Laparoscopic Cholecystectomy Common bile duct (CBD) stone occurs in about 3-15 % of patients undergoing laparoscopic cholecystectomy (LC) [1][2][3]. In the era of open cholecystectomy, preoperative endoscopic clearance of CBD followed by open cholecystectomy was comparable [4][5][6] or even considered inferior [7] to single-stage cholecystectomy and choledocholithotomy. With minimally invasive surgery becoming the 'gold standard,' the endoscopic approach has seen a revival and has been considered a viable alternative to laparoscopic CBD exploration for concomitant CBD stone. Traditionally, gallstones with CBD stones are managed in two sittings i.e., endoscopic clearance of CBD stone followed by laparoscopic cholecystectomy or vice versa [8]. This entails involvement of two teams led by the endoscopist and surgeon for CBD stones and gallstones, respectively. The endoscopic approach has been found to be similar to laparoscopic CBD exploration in terms of successful stone clearance, morbidity, and mortality except for longer hospital stay [9,10]. The latter disadvantage can be countered by carrying out the endoscopic CBD stone clearance as a single-sitting procedure in conjunction with LC [11]. The single-sitting approach, however, suffers from the logistic problem as it requires proper coordination between the surgeon and the endoscopist. We were encouraged to try this approach because of our considerable experience with both laparoscopy as well as endoscopy. We attempted to perform laparoscopic cholecystectomy as well as endoscopic clearance of the CBD stone ourselves without having the need to involve another team. In this report, we have presented our initial experience with this 'single-sitting' approach with respect to its...

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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‘Single-Sitting’ Laparoscopic Cholecystectomy and Endoscopic Removal of Common Bile Duct Stone for Cholelithiasis and Choledocholithiasis: a Feasibility Study

Ibrarullah¹,

Mishra²,

Dash³

et al. 2013

Indian J Surg

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“…Ahmed et al [10] compared preoperative versus intraoperative endoscopic sphincterotomy for management of CBD stones. 198 patients diagnosed preoperatively with gallbladder and CBD stones were eligible.…”

Section: Review Of Literaturementioning

confidence: 99%

“…There are only a few randomized trials available comparing the single stage with sequential management (ERCP followed by LC) of patients with concomitant gallstones and CBD stones [8,9]. Combined single stage laparoendoscopic approach to the management of choledocholithiasis has also been advocated by established centres [1,10] with results comparable to sequential management and single stage total laparoscopic exploration.…”

Section: Introductionmentioning

confidence: 99%

Management of Common Bile Duct Stones in the Laparoscopic Era

et al. 2012

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There is no consensus regarding the ideal management of concurrent gallbladder and common bile duct (CBD) stones. Currently the treatment protocol involves most commonly a sequential approach consisting of endoscopic sphincterotomy followed by laparoscopic cholecystectomy or a single stage laparoscopic procedure, including cholecystectomy and exploration of the CBD. For this article literature search was performed using online search engines, Google, Pubmed, the online Springer link library and the Cochrane Database Systematic Review. Review articles, prospective and retrospective studies which detailed or compared the various treatment strategies for CBD stones were selected and analyzed. This review article aims to provide an insight into the optimal management of CBD stones in different clinical scenarios. Endoscopic sphincterotomy has inherent morbidity and complications like CBD stone recurrence whereas laparoscopic CBD exploration demands considerable expertise which is available only at specialized centres. The clinical presentation of the patient, number of stones, size of CBD, available resources and technical expertise at hand are an important consideration for the ideal management in different scenarios.

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Initial Cholecystectomy vs Sequential Common Duct Endoscopic Assessment and Subsequent Cholecystectomy for Suspected Gallstone Migration

Iranmanesh

Frossard

Mugnier-Konrad

et al. 2014

JAMA

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Preoperative versus intraoperative endoscopic sphincterotomy for management of common bile duct stones

Abstract: PES/LC and LC/IOES are both good options for dealing with preoperatively diagnosed CBDS, but when there is enough experience and facilities, LC/IOES, as a single-stage treatment, would be preferable.

Cited by 56 publications

References 51 publications

‘Single-Sitting’ Laparoscopic Cholecystectomy and Endoscopic Removal of Common Bile Duct Stone for Cholelithiasis and Choledocholithiasis: a Feasibility Study

‘Single-Sitting’ Laparoscopic Cholecystectomy and Endoscopic Removal of Common Bile Duct Stone for Cholelithiasis and Choledocholithiasis: a Feasibility Study

Management of Common Bile Duct Stones in the Laparoscopic Era

Initial Cholecystectomy vs Sequential Common Duct Endoscopic Assessment and Subsequent Cholecystectomy for Suspected Gallstone Migration

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