Prevalence and characteristics of clinically significant retained common bile duct stones after laparoscopic cholecystectomy for symptomatic cholelithiasis

Lee, Doo-Ho; Ahn, Young Joon; Lee, Hae Won; Chung, Jung Kee; Jung, In Mok

doi:10.4174/astr.2016.91.5.239

Cited by 24 publications

(15 citation statements)

References 31 publications

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“…Some studies have suggested that the most cost-effective treatment strategy for most patients with symptomatic cholelithiasis involved laparoscopic cholecystectomy with routine IOC, as IOC could help surgeon to visualize the biliary anatomy and detect unexpected CBD stones [1819]. However, it remains debated whether IOC provides sufficient benefits in terms of its efficacy and safety to justify its routine application [1620]. In this study, there were no cases of IOC procedure to prevent bile duct injury in LSGB patient who underwent laparoscopic cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance and characteristics of left-sided gallbladder: case series study of 10 patients

et al. 2019

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PurposeThe aims of this case series study were to review the 10 patients who were diagnosed with left-sided gallbladder and analyze their anatomic variations in the bile duct, portal vein, and hepatic vessels.MethodsIn this case series study, 10 patients with left-sided gallbladder were retrospectively analyzed at 2 tertiary referral centers between April 2004 and May 2019.ResultsMean age was 61.1 years; there were 7 women and 3 men. Ten patients underwent laparoscopic cholecystectomy for acute cholecystitis or symptomatic gallbladder stone. The mean operation time was 77.2 minutes. Three ports were used in laparoscopic cholecystectomy procedures. The mean postoperative hospital stay was 3.5 days, and there were no cases of surgery-related morbidity. Two patients had type 1 bile duct and 3 had type 3 bile duct (2 type 3B and 1 type 3A). The right posterior portal vein as the first branch of the main portal vein was observed in all patients. Segment IV branches of the left portal vein crossing over to the segment VIII territory were observed in 7 of the 10 patients.ConclusionAlthough left-sided gallbladder is a very rare disease, it is possible to diagnose it preoperatively and perform laparoscopic cholecystectomy safely by adjusting port position. The common important features of left-sided gallbladder include distribution of the left portal vein crossing over to the right side of the liver and increased size of the left portal vein. These variations may have important clinical implications in the management of hepatic resection including donor hepatectomy.

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Section: Discussionmentioning

confidence: 99%

Clinical significance and characteristics of left-sided gallbladder: case series study of 10 patients

et al. 2019

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“…Among the ADPKD cases, gallstones and prior cholecystectomy were identified as risk factors for first cholangitis episode. The identification of prior cholecystectomy as a risk factor for cholangitis was unexpected and possibly explained by a residual risk of cholangitis in gallstone formers following cholecystectomy (due to retained common bile duct gallstones, the prevalence of which has been estimated at 1.8% in a Korean population who had cholecystectomy performed for symptomatic cholelithiasis 18 ).…”

Section: Discussionmentioning

confidence: 99%

Bacterial Cholangitis in Autosomal Dominant Polycystic Kidney and Liver Disease

Martin

Vaughan

Yoshida

et al. 2019

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Objective To describe first episodes of bacterial cholangitis complicating autosomal dominant polycystic kidney disease (ADPKD) and autosomal dominant polycystic liver disease (ADPLD) and to identify risk factors for cholangitis episodes among patients with ADPKD-associated polycystic liver disease (PLD). Patients and Methods We searched the electronic medical records at our tertiary referral center for episodes of cholangitis in patients with ADPKD or ADPLD from January 1, 1996, through June 30, 2017. Cases were categorized as suspected or definite cholangitis by expert review. Clinical, laboratory, and radiologic data were manually abstracted. A nested case-control study was conducted to investigate risk factors for cholangitis in patients with ADPKD. Results We identified 29 cases of definite or suspected cholangitis complicating PLD (24 with ADPKD-associated PLD and 5 with ADPLD). Among patients with definite cholangitis in ADPKD-associated PLD (n=19) vs ADPLD (n=4), the mean ± SD age was 62.4±12.2 vs 55.1±8.6 years, and 9 (47.4%) vs 0 (0%), respectively, were male. The odds of gallstones (odds ratio [OR], 21.6; 95% CI, 3.17-927; P <.001), prior cholecystectomy (OR, 12.2; 95% CI, 1.59-552; P =.008), duodenal diverticulum (OR, 13.5; 95% CI, 2.44 to not estimable; P =.004), type 2 diabetes mellitus (OR, 6.41; 95% CI, 1.01 to not estimable; P =.05), prior endoscopic retrograde cholangiopancreatography (OR, 14.0; 95% CI, 1.80-631; P =.005), and prior kidney transplant (OR, 8.06; 95% CI, 1.72-76.0; P =.004) were higher in patients with ADPKD-associated PLD with definite cholangitis compared to controls. Conclusion Gallstones, prior cholecystectomy, duodenal diverticulosis, type 2 diabetes mellitus, prior endoscopic retrograde cholangiopancreatography, and prior kidney transplant constituted risk factors for cholangitis among patients with ADPKD-associated PLD.

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“…The median quality score for the RCTs was judged based on the Cochrane Handbook 13 . The quality assessment stratifies the current evidence and projects the need for further research on the topic based on the quality of the available evidence into: high-quality evidence where further research is not expected to change the current confidence in the estimate of the effect size, moderate-quality evidence if further research is likely to influence confidence in the estimated effect and may change it; low-quality evidence if further research is very likely to influence confidence in the estimate of Reference Design n-RCT Phillips et al 36 Gigot et al 31 Millat et al 34 Arvidsson et al 20 Berthou et al 29 DePaula et al 27 Martin et al 33 Lauter and Froines 24 Michel et al 25 Tokumura et al 40 Waage et al 42 Topal et al 41 Jameel et al 22 Tan et al 39 Santo et al 38 Dimov et al 26 Darrien et al 21 Mohamed et al 35 Zhang et al 19 Aawsaj et al 28 Rhodes et al 37 Cuschieri et al 30 Grubnik et al 32 Overall n-RCT heterogeneity: I 2 = 68%, P < 0·05 RCT heterogeneity: I 2 = 72% P < 0·05 Heterogeneity: 2 Forest plot for successful duct clearance in patients with choledocholithiasis undergoing a laparoscopic transcystic or transcholedochal approach. Studies that had 100 per cent success in both arms 18,23 were not included in the analysis, so calculation of an odds ratio was not possible in the pooled analysis.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Concomitant common bile duct (CBD) stones are present in 3–15 per cent of patients with symptomatic cholelithiasis in the Western world. In approximately 2 per cent of patients these stones are considered clinically significant. These patients require CBD stone extraction for symptomatic relief and to prevent serious associated complications, including cholangitis, hepatic abscess and acute pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

Meta‐analysis of laparoscopic transcysticversustranscholedochal common bile duct exploration for choledocholithiasis

et al. 2019

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Background It is not clear whether laparoscopic transcystic exploration (LTCE) laparoscopic choledochotomy (LCD) is superior in the management of choledocholithiasis. In this meta‐analysis, the success of LTCE versus LCD was evaluated. Methods Cochrane Central Register of Controlled Trials, Web of Science, Trip, PubMed, Ovid and Embase databases were searched systematically for relevant literature up to May 2017. Studies that compared the success rate of LTCE and LCD in patients with choledocholithiasis were included. PRISMA guidelines were followed. Multiple independent reviewers contributed on a cloud‐based platform. Random‐effects model was used to calculate odds ratios (ORs) or standardized mean differences (MDs) with 95 per cent confidence intervals. An a priori hypothesis was generated based on clinical experience that LTCE is as successful as LCD. Results Of 3533 screened articles, 25 studies comprising 4224 patients were included. LTCE achieved a lower duct clearance rate than LCD (OR 0.38, 95 per cent c.i. 0·24 to 0·59). It was associated with a shorter duration of surgery (MD −0·86, 95 per cent c.i. −0·97 to −0·77), lower bile leak (OR 0·46, 0·23 to 0·93) and shorter hospital stay (MD −0·78, −1·14 to −0·42) than LCD. There was no statistically significant difference in conversion, stricture formation or reintervention rate. Conclusion LCD has a higher rate of successful duct clearance, but is associated with a longer duration of surgery and hospital stay, and a higher bile leak rate.

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Prevalence and characteristics of clinically significant retained common bile duct stones after laparoscopic cholecystectomy for symptomatic cholelithiasis

Cited by 24 publications

References 31 publications

Clinical significance and characteristics of left-sided gallbladder: case series study of 10 patients

Clinical significance and characteristics of left-sided gallbladder: case series study of 10 patients

Bacterial Cholangitis in Autosomal Dominant Polycystic Kidney and Liver Disease

Meta‐analysis of laparoscopic transcysticversustranscholedochal common bile duct exploration for choledocholithiasis

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