Systematic review and meta-analysis of intraoperative <i>versus</i> preoperative endoscopic sphincterotomy in patients with gallbladder and suspected common bile duct stones

Gurusamy, Kurinchi Selvan; Sahay, Samir; Burroughs, A.K.; Davidson, Brian R

doi:10.1002/bjs.7460

Cited by 72 publications

(49 citation statements)

References 52 publications

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“…A meta-analysis of randomized trials confirmed that IOES during LC is as effective and safe as postoperative therapeutic ERCP and results in significantly shorter hospital stay [43]. Intraoperative ERCP during LC has many theoretical benefits.…”

Section: Percutaneous Tube Drainage Followed By Ercp and Stenting Wasmentioning

confidence: 88%

Intraoperative ERCP for management of cholecystocholedocholithiasis

2016

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Section: Percutaneous Tube Drainage Followed By Ercp and Stenting Wasmentioning

confidence: 88%

Intraoperative ERCP for management of cholecystocholedocholithiasis

2016

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“…A meta-analysis of four RCTs involving 532 patients comparing preoperative EST and intraoperative EST using the rendezvous technique reported that post-EST complications occurred at a significantly lower rate and hospital stays were significantly shorter with intraoperative EST. There was no difference in the stone removal rate [127]. Although the intraoperative rendezvous technique facilitates bile duct cannulation and is expected to reduce the incidence of pancreatitis and other complications, it can be performed only at resource-rich institutions because it requires prolonged surgery time and an endoscopic specialist to be available in the operating room.…”

Section: Commentarymentioning

confidence: 98%

“…The surgical procedures in this meta-analysis included open (seven trials) and laparoscopic (five trials) procedures, and the subanalysis also did not reveal any differences. When cholecystectomy was performed at the same time as the treatment for choledocholithiasis, the hospital stay was reduced compared with two-stage treatment despite there being no difference in the stone removal rate [126,127]. However, a prospective national survey conducted by the Japan Biliary Association Scientific Committee [128] (literature published outside the search period) reported that only 3 of 77 cases of choledocholithiasis were treated surgically (3.9%), one with laparoscopic surgery and two with open choledochotomy.…”

Section: Commentarymentioning

confidence: 99%

Evidence-based clinical practice guidelines for cholelithiasis 2016

Tazuma

Unno²,

Igarashi³

et al. 2016

J Gastroenterol

213

178

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Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories-epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications-were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This article preferentially describes the clinical management of cholelithiasis and its complications. Following description of the diagnosis performed stepwise through imaging modalities, treatments of cholecystolithiasis, choledocholithiasis, and hepatolithiasis are introduced along with a flowchart. Since there have been remarkable improvements in endoscopic treatments and surgical techniques, the guidelines ensure flexibility in choices according to the actual clinical environment. The revised clinical practice guidelines are appropriate for use by clinicians in their daily practice.

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“…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%

‘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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Systematic review and meta-analysis of intraoperative versus preoperative endoscopic sphincterotomy in patients with gallbladder and suspected common bile duct stones

Abstract: In patients with gallbladder and common bile duct stones, IOES is as effective and safe as POES and results in a significantly shorter hospital stay.

Cited by 72 publications

References 52 publications

Intraoperative ERCP for management of cholecystocholedocholithiasis

Intraoperative ERCP for management of cholecystocholedocholithiasis

Evidence-based clinical practice guidelines for cholelithiasis 2016

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

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