The case for laparoscopic common bile duct exploration

Fielding, George

doi:10.1007/s005340200099

Cited by 11 publications

(8 citation statements)

References 34 publications

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“…Although the cumulative incidence of complications for the CBDE group was higher than that for the ERCP group in our study, both were similar to the 5.6% cumulative incidence reported by Petelin [14]. Factors contributing to the decrease in CBDE were the reduced use of routine intraoperative cholangiography during LC, perceived higher cost, and increased operative time [7]. With reduced exposure to open CBDE, increased training in advanced laparoscopic CBDE techniques may provide opportunities to reduce hospital utilization and avoid additional procedures.…”

Section: Discussionsupporting

confidence: 90%

National analysis of in-hospital resource utilization in choledocholithiasis management using propensity scores

2005

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Section: Discussionsupporting

confidence: 90%

National analysis of in-hospital resource utilization in choledocholithiasis management using propensity scores

2005

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“…Primary closure of the common bile duct is sometimes adequate for choledocholithotomy, as long as there are no residual stones or debris in the common bile duct, no interference with passage to the duodenum, no infected bile, and no inflammation of the common bile duct. Fielding5 reported that primary closure can be safely performed in patients without distal obstruction, in whom there has been easy clearance of the duct. Primary closure of the common bile duct is both safe and effective 6.…”

Section: Discussionmentioning

confidence: 99%

Placement of a double-pigtail ERBD tube after primary closure of the common bile duct in three patients with choledocholithiasis

Fujii

Okino

Fujioka

et al. 2005

J Hepatobiliary Pancreat Surg

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We devised a procedure for the placement of a double-pigtail endoscopic retrograde biliary drainage (ERBD) tube as an alternative to the placement of a T-tube. We used the procedure, after primary closure of the common bile duct, in three patients undergoing surgery for choledocholithiasis. All three patients were in their eighties, and all were diagnosed with cholecystolithiasis and choledocholithiasis. In all three, there were concerns about possible complications with the use of a T-tube. Two of the patients were senile and were thought to be likely to pull out the tube, and incomplete fistulation was considered possible in the third patient. Thus, there was an increased risk of bile peritonitis in all three patients. Placement of the ERBD tube was successful in all three patients, and there were no postoperative complications. The hospital stay was a few weeks shorter than the usual stay with the placement of a T-tube. We conclude that primary closure of the common bile duct with the placement of a double-pigtail ERBD tube is clinically safe and advantageous for choledocholithiasis patients with senile dementia and for patients with possible incomplete fistulation.

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“…ERCP has a mortality and morbidity rate of up to 1% and 15.9%, respectively. 3,4 Furthermore, patients who opt for preoperative ERCP may still require CBDE if stone clearance is not achieved and may eventually end up having multiple procedures. [5][6][7] Although laparoscopic common bile duct exploration (LCBDE) is an accepted treatment, the technical difficulties associated with this procedure have made it slower to gain widespread acceptance.…”

mentioning

confidence: 99%

Common Bile Duct Exploration in an Elderly Asian Population

Shelat

Chia

Low

2015

International Surgery

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Common bile duct exploration (CBDE) is an accepted treatment for choledocholithiasis. This procedure is not well studied in the elderly population. Here we evaluate the results of CBDE in elderly patients (.70 years) and compare the open (group A) with the laparoscopic group (group B). A retrospective review was performed of elderly patients with proven common bile duct (CBD) stones who underwent CBDE from January 2005 to December 2009. There were 55 patients in group A and 33 patients in group B. Mean age was 77.6 years (70-91 years). Both groups had similar demographics, liver function tests, and stone size-12 mm (range, 5-28 mm). Patients who had empyema (n ¼ 9), acute cholecystitis (n ¼ 15), and those who had had emergency surgery (n ¼ 28) were more likely to be in group A (P , 0.05). The mean length of stay for group A was 11.7 6 7.3 days; for group B, 5.2 6 6.3 days; the complication rate was higher in group A (group A, 38.2%; group B, 8.5%; P ¼ 0.072). The overall complication and mortality rate was 29.5% and 3.4%, respectively. CBDE can be performed safely in the elderly with accepted morbidity and mortality. The laparoscopic approach is feasible and safe in elective setting even in the elderly.

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The case for laparoscopic common bile duct exploration

Cited by 11 publications

References 34 publications

National analysis of in-hospital resource utilization in choledocholithiasis management using propensity scores

National analysis of in-hospital resource utilization in choledocholithiasis management using propensity scores

Placement of a double-pigtail ERBD tube after primary closure of the common bile duct in three patients with choledocholithiasis

Common Bile Duct Exploration in an Elderly Asian Population

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