Safety and efficacy of a novel continuous incision technique for laparoscopic transcystic choledocholithotomy

Otani, Tetsuya; Yokoyama, Naoyuki; Sato, Daisuke; Kobayashi, Kazuo; Iwaya, Akira; Kuwabara, Shirou; Yamazaki, Toshiyuki; Matsuzawa, Natsumi; Saito, Hideki; Katayanagi, Norio

doi:10.1111/ases.12363

Cited by 10 publications

(4 citation statements)

References 25 publications

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“…In the hospitals participating in our study, the proportion of LCBDE for treatment of CBDS patients was 1.8À19% for each hospital (data not shown). However, patients with multiple stones, duodenal diverticulum, severe strictures or obstructions, and severe kyphosis will require surgical methods [11,17,[20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Recurrence of common bile duct stones following laparoscopic common bile duct exploration: a multicenter study

Park

Hong

Lee

et al. 2019

J Hepato Biliary Pancreat

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Background Recurrence of common bile duct stone (CBDS) is not common after laparoscopic common bile duct exploration (LCBDE). This study aimed to investigate the risk factors of recurrence of CBDS after LCBDE. Methods Patients who underwent LCBDE between January 2001 and December 2018 in four teaching hospitals of The Catholic University of Korea were included. The operation, fluoroscopy, and endoscopic retrograde cholangiopancreatography records were investigated retrospectively. The primary outcome of this study was the independent risk factors for recurrence of CBDS. Results A total of 230 patients were included in this study. Thirty‐one patients had recurrence of CBDS. In univariate analysis, CBDS size (>9 mm) (P = 0.003), multiple stones (≥2) (P = 0.031), stone size (≥1.5 cm) (P = 0.041), CBD diameter (≥12 mm) (P = 0.005), CBD dilatation (≥10 mm) (P = 0.02), prior history of laparoscopic cholecystectomy (P = 0.002) were associated with recurrence. After multivariable logistic regression, CBDS size (>9 mm) (OR 4.67, 95% CI 1.35–16.18, P = 0.011), CBD dilatation (≥10 mm) (OR 5.66, 95% CI 1.47–21.82, P = 0.012), and prior history of laparoscopic cholecystectomy (AOR 3. 90, 95% CI 1.34–11.37, P = 0.013) were associated with recurrence. Conclusions Stone size >9 mm, CBD diameter ≥10 mm, and prior history of laparoscopic cholecystectomy were risk factors for recurrence of CBDS after LCBDE.

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Section: Discussionmentioning

confidence: 99%

Recurrence of common bile duct stones following laparoscopic common bile duct exploration: a multicenter study

Park

Hong

Lee

et al. 2019

J Hepato Biliary Pancreat

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“…Laparoscopic choledocholithotomy with transcystic C-tube drainage results in an excellent rate of stone clearance, less bile leakage, less blood loss, acceptable mortality and morbidity rates, shortened hospital stay, and earlier social reintegration than conventional open surgery with transductal T-tube drainage[22,27,69,106-109]. However, in a laparoscopic approach, operative time was prolonged and cost becomes more expensive[110,111].…”

Section: Discussionmentioning

confidence: 99%

“…Operative time is greatly affected by the duration of stone removal[73,74]; detailed preoperative imaging studies shorten operative time[77]. Removal of impacted and/or large stones is especially difficult[27,73], although even an impacted stone will float after preoperative biliary drainage[76]. Preoperative evaluation with endoscopic retrograde cholangiography or cholangiography via drainage tube is strongly recommended[78].…”

Section: Preoperative Evaluation Of Bile Duct Stonesmentioning

confidence: 99%

Comprehensive and innovative techniques for laparoscopic choledocholithotomy: A surgical guide to successfully accomplish this advanced manipulation

Hori

2019

WJG

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Surgeries for benign diseases of the extrahepatic bile duct (EHBD) are classified as lithotomy ( i.e ., choledocholithotomy) or diversion ( i.e ., choledochojejunostomy). Because of technical challenges, laparoscopic approaches for these surgeries have not gained worldwide popularity. The right upper quadrant of the abdomen is advantageous for laparoscopic procedures, and laparoscopic choledochojejunostomy is safe and feasible. Herein, we summarize tips and pitfalls in the actual procedures of choledocholithotomy. Laparoscopic choledocholithotomy with primary closure of the transductal incision and transcystic C-tube drainage has excellent clinical outcomes; however, emergent biliary drainage without endoscopic sphincterotomy and preoperative removal of anesthetic risk factors are required. Elastic suture should never be ligated directly on the cystic duct. Interrupted suture placement is the first choice for hemostasis near the EHBD. To prevent progressive laceration of the EHBD, full-layer interrupted sutures are placed at the upper and lower edges of the transductal incision. Cholangioscopy has only two-way operation; using dedicated forceps to atraumatically grasp the cholangioscope is important for smart maneuvering. The duration of intraoperative stone clearance accounts for most of the operative time. Moreover, dedicated forceps are an important instrument for atraumatic grasping of the cholangioscope. Damage to the cholangioscope requires expensive repair. Laparoscopic approach for choledocholithotomy involves technical difficulties. I hope this document with the visual explanation and literature review will be informative for skillful surgeons.

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“…[16] Some authors consider the transcystic approach as risky in stones of larger than 20 mm. [17] There is no unanimous opinion regarding the completion of choledochotomy with T-drainage, primary suture or stend, which is another issue of laparoscopic choledochotomy. We used T-drainage in all patients during our study, and T-drainage dislocation was observed in one patient, which was resolved by relaparoscopy.…”

Section: Discussionmentioning

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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Safety and efficacy of a novel continuous incision technique for laparoscopic transcystic choledocholithotomy

Abstract: Introduction: The purpose of this study was to evaluate the safety and efficacy of a

Cited by 10 publications

References 25 publications

Recurrence of common bile duct stones following laparoscopic common bile duct exploration: a multicenter study

Recurrence of common bile duct stones following laparoscopic common bile duct exploration: a multicenter study

Comprehensive and innovative techniques for laparoscopic choledocholithotomy: A surgical guide to successfully accomplish this advanced manipulation

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

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