Tratamiento laparoscópico de la litiasis de la vía biliar principal asociada a litiasis vesicular

Mandry, Alexandra Catalina; Bun, Maximiliano; Aued, María Laura; Iovaldi, Mario L.; Capitanich, Pablo

doi:10.1016/s0009-739x(08)70493-7

Cited by 6 publications

(2 citation statements)

References 18 publications

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“…Several randomized controlled trials showed similar effectiveness for both methods of treatment [38,39]. Patients treated with LCBDE had a significantly shorter hospital stay and lower hospital costs as compared with ERCP/EST [40,41,42]. …”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Exploration versus Intraoperative Endoscopic Sphincterotomy for Common Bile Duct Stones: A Prospective Randomized Trial

Elgeidie¹,

Elshobary²,

Naeem³

2011

Dig Surg

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Background/Aims: Laparoscopic cholecystectomy (LC) combined with intraoperative endoscopic sphincterotomy (IOES) was compared to LC with laparoscopic common bile duct exploration (LCBDE) to define the best single-session minimally invasive treatment for cholecystocholedocholithiasis. Methods: Between June 2009 and December 2010, patients with gallstones and common bile duct (CBD) stones diagnosed by preoperative ultrasonography and magnetic resonance cholangiopancreatography were randomized to LC-LCBDE or LC-IOES. The primary end point was complete clearance of CBD of stones. The secondary end points were operation time, conversion rate, length of hospital stay, complications and mortality. Results: Two hundred and twenty-six patients were eligible. They were randomized to LC-LCBDE (n = 115) and LC-IOES (n = 111). There was no statistically significant difference in the success rate of CBD clearance between the two interventions (92% for LC-LCBDE vs. 97.2% for LC-IOES with a p value >0.05). There were no differences between the two groups in terms of surgical time and postoperative length of stay. Pancreatitis and bleeding sphincterotomy were significantly more prevalent in the LC-IOES group, while bile leakage and retained CBD stones were significantly more prevalent in the LC-LCBDE group. Conclusion: Both LC-IOES and LC-LCBDE were shown to be safe, effective, minimally invasive treatments for cholecystocholedocholithiasis, but the former option may be preferred when facilities and experience in endoscopic therapy exist.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Exploration versus Intraoperative Endoscopic Sphincterotomy for Common Bile Duct Stones: A Prospective Randomized Trial

Elgeidie¹,

Elshobary²,

Naeem³

2011

Dig Surg

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“…With advancing technology and minimally invasive surgery, laparoscopic biliary surgery has become safe, efficient, and cost effective [87–89]. Laparoscopic common bile duct exploration (LCBDE) was associated with successful stone clearance rates ranging from 85% to 95%, a morbidity rate of 4%–16% and a mortality rate of around 0%–2% [90, 91].…”

Section: Treatmentmentioning

confidence: 99%

Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

Shojaiefard

Esmaeilzadeh

Ghafouri

et al. 2009

Gastroenterology Research and Practice

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Common bile duct stones (CBDSs) may occur in up to 3%–14.7% of all patients for whom cholecystectomy is preformed. Patients presenting with CBDS have symptoms including: biliary colic, jaundice, cholangitis, pancreatitis or may be asymptomatic. It is important to distinguish between primary and secondary stones, because the treatment approach varies. Stones found before, during, and after cholecystectomy had also differing treatments. Different methods have been used for the treatment of CBDS but the suitable therapy depends on conditions such as patient' satisfaction, number and size of stones, and the surgeons experience in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD exploration (transcystic or transcholedochal), or laparotomy with CBD exploration (by T-tube, C-tube insertion, or primary closure) are the most commonly used methods managing CBDS. We will review the pathophysiology of CBDS, diagnosis, and different techniques of treatment with especial focus on the various surgical modalities.

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Two-Port Laparoscopic Common Bile Duct Exploration with T-tube Choledochostomy for Management of Choledocholithiasis: An Initial Clinical Report

Sun

Wang

Wen

et al. 2011

The American Surgeon™

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Laparoscopic common bile duct exploration (LCBDE) is generally performed using a four- or five-port technique. We report a unique technique of two-port transcholedochal LCBDE with T-tube placement. Twelve consecutive patients with common bile duct (CBD) stones underwent LCBDE through two entry ports, one homemade single port (Uen port) inserted in a 2-cm umbilical wound and one 5-mm subxiphoid trocar port. With the assistance of a 1.2-mm needle that was inserted through a right lower intercostal space into the abdominal cavity to facilitate the operation, two-port dome-down laparoscopic cholecystectomy, choledochotomy, choledochoscopic removal of ductal caculi, and T-tube choldochostomy were performed with conventional methods using standard laparoscopic instruments along with manually operated angled shafts. After completion of the operation, the T-tube catheter was brought out through the subxiphoid trocar wound. All operations were completed successfully without the need of additional ports. There was no complication and no residual stones. Mean operation time was 120 minutes (range, 90 to 150 minutes), and mean postoperative hospital stay was 3.5 days (range, 3 to 4 days). Scarless wound healing was achieved except one T-tube scar. Two-port transumbilical LCBDE with T-tube choledochostomy is a feasible, safe, and effective technique that allows one-scar abdominal surgery for treatment of CBD stones. Further studies and the development of better instruments are necessary before this can be recommended as a standard procedure.

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Tratamiento laparoscópico de la litiasis de la vía biliar principal asociada a litiasis vesicular

Cited by 6 publications

References 18 publications

Laparoscopic Exploration versus Intraoperative Endoscopic Sphincterotomy for Common Bile Duct Stones: A Prospective Randomized Trial

Laparoscopic Exploration versus Intraoperative Endoscopic Sphincterotomy for Common Bile Duct Stones: A Prospective Randomized Trial

Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

Two-Port Laparoscopic Common Bile Duct Exploration with T-tube Choledochostomy for Management of Choledocholithiasis: An Initial Clinical Report

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