Sphincter of Oddi‐preserving and T‐Tube‐free Laparoscopic Management of Extrahepatic Bile Duct Calculi

Chen, Chun-Chih; Wu, Shuodong; Tian, Yu; Siwo, Ernest Amos; Zeng, Xintao; Zhang, Guanghui

doi:10.1007/s00268-011-1193-5

Cited by 16 publications

(12 citation statements)

References 39 publications

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“…The problem of T-tube insertion is still debatable and primary closure of the bile duct after exploration with or without biliary stent is in vogue at the moment. 19 26 27 28 29 30 We inserted T-tubes in all cases as a route for identification and removal of the possible residual stones.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic common bile duct exploration in patients with previous upper abdominal operations

Yun

Ahn

Lee

et al. 2012

Korean J Hepatobiliary Pancreat Surg

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Backgrounds/AimsWe aimed to to evaluate the feasibility of laparoscopic common bile duct exploration (LCBDE) in patients with previous upper abdominal surgery.MethodsRetrospective analysis was performed on data from the attempted laparoscopic common bile duct exploration in 44 patients. Among them, 5 patients with previous lower abdominal operation were excluded. 39 patients were divided into two groups according to presence of previous upper abdominal operation; Group A: patients without history of abdominal operation. (n=27), Group B: patients with history of upper abdominal operation. Both groups (n=12) were compared to each other, with respect to clinical characteristics, operation time, postoperative hospital stay, open conversion rate, postoperative complication, duct clearance and mortality.ResultsAll of the 39 patients received laparoscopic common bile duct exploration and choledochotomy with T-tube drainage (n=38 [97.4%]) or with primary closure (n=1). These two groups were not statistically different in gender, mean age and presence of co-morbidity, mean operation time (164.5±63.1 min in group A and 134.8±45.2 min in group B, p=0.18) and postoperative hospital stay (12.6±5.7 days in group A and 9.8±2.9 days in group B, p=0.158). Duct clearance and complication rates were comparable (p>0.05). 4 cases were converted to open in group A and 1 case in group B respectively. In group A (4 of 27 (14.8%) and 1 of 12 (8.3%) in group B, p=0.312) Trocar or Veress needle related complication did not occur in either group.ConclusionsLCBDE appears to be a safe and effective treatment even in the patients with previous upper abdominal operation if performed by experienced laparoscopic surgeon, and it can be the best alternative to failed endoscopic retrograde cholangiopancreatography for difficult cholelithiasis.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic common bile duct exploration in patients with previous upper abdominal operations

Yun

Ahn

Lee

et al. 2012

Korean J Hepatobiliary Pancreat Surg

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“…For the primary biliary surgical procedure, if the stones are small (r6 mm) and the common bile duct diameter is thin (r8 mm), endoscopic papillary balloon dilatation can be used to avoid irreversible SO muscle fiber damage, it has been reported that SO function will return to normal 21 days after endoscopic papillary balloon dilatation. 20 For patients with large stones (Z7 mm) undergoing the primary biliary surgical procedure, we should avoid EST directly and choose LCBDE or LCBDE without a Ttube [if the bile duct is coarse (Z10 mm) and all stones can be removed] 21 to preserve SO function as much as possible, which can reduce the likelihood of duodenobiliary reflux and reduce the risk of stone recurrence. In contrast, LCBDE also has some advantages with respect to length of hospital stay and associated hospital costs.…”

Section: Discussionmentioning

confidence: 99%

A Randomized, Clinical Trial Involving Different Surgical Methods Affecting the Sphincter of Oddi in Patients With Choledocholithiasis

Yin

Gao²,

Zang³

et al. 2016

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Overall cost also is high. Besides, EST could cause partial damage to the SO, and could arise EST‐related complications such as reflux cholangitis, recurrence of bile duct stones, and bile duct cancer . From this perspective, EST is still controversial.…”

Section: Discussionmentioning

confidence: 99%

T‐tube‐free single‐incision laparoscopic common bile duct exploration plus cholecystectomy: a single centre experience

Yao

Tian

Yao

et al. 2019

ANZ Journal of Surgery

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Background The present study aimed to explore the indications and feasibility of T‐tube‐free trans‐umbilical single‐incision laparoscopic common bile duct exploration (SILCBDE) plus laparoscopic cholecystectomy (LC) for treating choledocholithiasis. Methods Patients hospitalized in the Second Affiliated Hospital (Shengjing Hospital) of China Medical University from January 2010 to January 2017 with the diagnosis of common bile duct stones and treated with T‐tube‐free trans‐umbilical single‐incision LC plus common bile duct exploration were retrospectively analysed. Results A total of 37 male/female choledocholithiasis patients (mean age 65 years, range 29–86) were treated with T‐tube‐free trans‐umbilical SILCBDE plus LC. No intraoperative complication or conversion to open surgery occurred in any of the cases. The mean operative time was 99.8 min (range 84–125) for endoscopic nasobiliary drainage group (n = 6), 113.8 min (range 70–150) for endoscopic retrogradebiliary drainage group (n = 2), 131.1 min (range 75–161) for pigtail J‐tube group (n = 24), 113.7 min (range 100–150) for primary closure group (n = 5). The mean post‐operative hospital stay length was 5.5 days (range 4–7) for endoscopic nasobiliary drainage group, 12.5 days (range 10–15) for endoscopic retrogradebiliary drainage group, 6.5 days (range 4–10) for J‐tube group, 5.8 days (range 4–9) for primary closure group. Pancreatitis, bile leakage and peritonitis were not presented in any of the group. After 17–101 months follow‐up, three patients presented recurrent common bile duct stones. Conclusion In selected cases, T‐tube‐free trans‐umbilical SILCBDE plus LC is feasible and safe for experienced surgeons, and can achieve similar therapeutic effects as common LC plus common bile duct exploration procedures.

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Sphincter of Oddi‐preserving and T‐Tube‐free Laparoscopic Management of Extrahepatic Bile Duct Calculi

Cited by 16 publications

References 39 publications

Laparoscopic common bile duct exploration in patients with previous upper abdominal operations

Laparoscopic common bile duct exploration in patients with previous upper abdominal operations

A Randomized, Clinical Trial Involving Different Surgical Methods Affecting the Sphincter of Oddi in Patients With Choledocholithiasis

T‐tube‐free single‐incision laparoscopic common bile duct exploration plus cholecystectomy: a single centre experience

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