Single-incision laparoscopic common bile duct exploration in 101 consecutive patients: choledochotomy, transcystic, and transfistulous approaches

Chuang, Shu‐Hung; Hung, Min-Chang; Huang, Shih-Wei; Chou, Dev-Aur; Wu, Hurng‐Sheng

doi:10.1007/s00464-017-5658-y

Cited by 10 publications

(8 citation statements)

References 29 publications

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“…Furthermore, Chuang et al described a novel LESS transfistulous bile duct exploration and stone removal without drainage for Mirizzi syndrome type II with 80% success rate [73]. Supporting previous results and adding more evidence to the safety of the technique, the same authors reported 101 consecutive cases of successful LESS CBD exploration and concluded that in experienced hands, the procedure is feasible and a safe option for treatment of complicated and noncomplicated choledocholithiasis under low threshold for conversion [74].…”

Section: Less Common Bile Duct Explorationmentioning

confidence: 85%

LaparoEndoscopic Single-Site Upper Gastrointestinal Surgery

Hamid¹,

Johnston²

2019

Recent Advances in Laparoscopic Surgery [Working Title]

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The evolution of minimally invasive surgery has led to the development of laparoendoscopic single-site (LESS) surgery. The feasibility of almost all types of LESS upper (GI) procedures has been shown. During the learning phase, substantial experience in both laparoscopy and upper GI surgery and stringent patient selection criteria is essential for successful and safe application of the technique, especially in complex procedures. Comparative studies between LESS and conventional laparoscopy for various upper GI procedures suggest a non-inferiority of LESS over standard laparoscopy, although the only objective benefit remains an improved cosmetic outcome. Intracorporeal instrument collision, lack of triangulation, and in-line vision are among the main challenges of LESS surgery. The current review provides a comprehensive report of the specific applications of LESS in upper GI surgery, with a special reference to advances made to overcome the current technical difficulties and future perspectives.

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Section: Less Common Bile Duct Explorationmentioning

confidence: 85%

LaparoEndoscopic Single-Site Upper Gastrointestinal Surgery

Hamid¹,

Johnston²

2019

Recent Advances in Laparoscopic Surgery [Working Title]

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“…The single-incision LCBDE (SILCBDE) technique has been described in detail previously[ 22 , 23 ]. The patient was given general anesthesia and placed in the reverse Trendelenburg position.…”

Section: Literature Review and Our Own Experiencementioning

confidence: 99%

“…Compared with the difficulty in LCBDE for SI patients, SILCBDE seems to have some advantages. We developed this novel technique in July 2012, and it soon became our standard of care for choledocholithiasis, including difficult situations such as Mirizzi syndrome Csendes type II-IV[ 22 , 23 , 60 ]. In addition to a 5-mm 50-cm-long 30-degree laparoscope and a 5-mm flexible fiber choledochosope set, only conventional straight laparoscopic instruments were needed.…”

Section: Laparoscopic Common Bile Duct Exploration In Situs Inversus ...mentioning

confidence: 99%

Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients: A technical review

Chiu¹,

Chuang²,

Chuang³

et al. 2023

World J Clin Cases

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Situs inversus (SI) is a rare congenital condition characterized by a mirror-image transposition of the major visceral organs. Since the 1990s, more than one hundred SI patients have been reported to have successfully undergone laparoscopic cholecystectomy. In these cases, the major problem is to overcome is the left-right condition for right-handed surgeons. Laparoscopic common bile duct exploration (LCBDE), an alternative to treat patients with bile duct stones, has shown equivalent efficacy and is less likely to cause pancreatitis than endoscopic retrograde cholangiopancreatography. Recent updated meta-analyses revealed that a shorter postoperative hospital stay, fewer procedural interventions, cost-effectiveness, a higher stone clearance rate, and fewer perioperative complications are additional advantages of LCBDE. However, the technique is technically demanding, even for skilled laparoscopic surgeons. Conducting LCBDE in patients with difficult situations, such as SI, is more complex than usual. We herein review published SI patients with choledocholithiasis treated by LCBDE, including our own experience, and this paper focuses on the technical aspects.

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“…The clinical outcomes compare favorably with published studies (Table 6). [41][42][43][44][45][46][47][48] They encouraged our gastroenterologists to discontinue the on-site ERCP service 24 years ago. In addition, we prospectively measured important outcomes including the referral to surgery and presentation to resolution intervals and the number of episodes.…”

Section: Role Of Subspecialisation and Service Designmentioning

confidence: 99%

Conventional Surgical Management of Bile Duct Stones

Nassar

Katbeh

et al. 2020

Annals of Surgery

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Objective: The primary aim of this study was to describe the service model of one-session management, with a limited role for preoperative endoscopic clearance. The secondary aim was to review the outcomes and long term follow up in comparison to available studies on LCBDE. Background: The laparoscopic era brought about a decline in the conventional surgical management of common bile duct stones. Preoperative endoscopic removal became the primary method of managing choledocholithiasis. Although LCBDE deals with gallstones and ductal stones in onw session, the limited availability of such an advanced procedure perpetuated the reliance on the endoscopic approach. Methods: Prospective data was entered into a single surgeon's database containing 5739 laparoscopic cholecystectomy over 28 years and analyzed. Results: One thousand eighteen consecutive LCBDE were included (23% of the series). Intraoperative cholangiography was performed in 1292 (98.0%). The median age was 60 years, male to female ratio 1:2 and 75% were emergency admissions. Most patients (43.4%) presented with jaundice. 66% had transcystic explorations and one third through a choledochotomy with 2.1% retained stones, 1.2% conversion, 18.7% morbidity, and 0.2% mortality. Postoperative ERCPs were needed in 3.1%. Recurrent stones occurred in 3%. Conclusions: One stage LCBDE is a safe and cost-effective treatment where the expertise and equipment are available. Endoscopic treatment has a role for specific indications but remains the first-line treatment in most units. This study demonstrates that establishing specialist services through training and logistic support can optimize the outcomes of managing common bile duct stones.

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Single-incision laparoscopic common bile duct exploration in 101 consecutive patients: choledochotomy, transcystic, and transfistulous approaches

Cited by 10 publications

References 29 publications

LaparoEndoscopic Single-Site Upper Gastrointestinal Surgery

LaparoEndoscopic Single-Site Upper Gastrointestinal Surgery

Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients: A technical review

Conventional Surgical Management of Bile Duct Stones

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