The Role of ERCP and Therapeutic Biliary Endoscopy in Laparoscopic Cholecystectomy

Yau, Man-Pun; Hwang, Myung Jin; Lin, Ruey‐Chang; Kuo, Jenn-Yuan; Tsai, Chien-Chung

doi:10.1089/lps.1993.3.19

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…With the introduction of laparoscopy in general surgery, the management of CBD stones has diversified into preoperative management with ERCP, ES, and stone extraction; perioperative ES;22 and laparoscopic CBD exploration and postoperative ERCP in residual patients with stones 17. Although laparoscopic CBD exploration has been reported,23 it is not a routine procedure and is only regularly performed in some institutions.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative endoscopic sphincterotomy in the treatment of patients with cholecystocholedocholithiasis

Chang

Wang

Yau

et al. 2002

Journal of Hepato-Biliary-Pancreatic Surgery

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Preoperative endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) prior to laparoscopic cholecystectomy (LC) are the most common methods for the diagnosis and treatment of patients with cholecystocholedocholithiasis. We evaluated the selection criteria for preoperative ERCP examination and the results of endoscopic-laparoscopic treatment of patients with choledocholithiasis. Between January 1993 and December 1998, 1630 patients with symptomatic cholelithiasis were admitted for surgical intervention. Preoperative ERCP was performed in 247 patients according to the selection criteria. The criteria to perform ERCP were dilated common bile duct (CBD; more than 8 mm), abnormal serum liver test results, and a recent history of pancreatitis. Endoscopic sphincterotomy (ES) was performed if CBD stones were found during the procedure. LC was then carried out within 3 days after ES. Of the 247 patients selected for preoperative ERCP, CBD stones were confirmed in 146 patients (59.1%). ES was successful in 141 patients, and stone clearance was achieved in 133 patients, resulting in a 94.3% success rate. Eight patients (5.5%) had complications after endoscopic intervention, all of which resolved uneventfully. Open operative procedures were carried out in a total of 31 patients. Overall, 115 patients were successfully treated by this endoscopic laparoscopic sequence. The length of hospital stay in these groups was significantly lower than that for patients in whom an open method was employed. Preoperative ES combined with LC is a safe and effective therapy for cholecystocholedocholithiasis, and the criteria that we used for the selection of patients seem to be appropriate.

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Section: Discussionmentioning

confidence: 99%

“…For those patients with cholecystocholedocholithiasis, the procedures for removal of common bile duct (CBD) stones are controversial. Preoperative endoscopic sphincterotomy (ES) is one of the choices for treatment . We report our experience of endoscopic sphincterotomy prior to laparoscopic cholecystectomy in a recent 6‐years period.…”

Section: Introductionmentioning

confidence: 99%