Why is there recurrence after transcystic laparoscopic bile duct clearance? Risk factor analysis

Abstract

TC-CBDE is safe and effective in the majority of cases of CBDS. The incidence of recurrence is low but there are some risk factors, such as number of stones >3 with biliary sludge, which do not favor the successful outcome of the procedure. In such cases, it is essential that the TC-CBDE is integrated with other procedures which, although more complex, assure the clearance of the bile duct.

Laparoscopic management of CBD stones: an Indian experience

“…The patient made a quick recovery and was asymptomatic on further follow-up. Most published reports for LCBDE do not provide long-term follow-up statistics; however, the few that do report recurrent stones in 1.8-6.7% of patients [25,[47][48][49]. We encountered this complication in only one patient (0.75%).…”

Laparoscopic transcystic exploration for single-stage management of common duct stones and acute cholecystitis

“…The clearance rate that we recorded for LTCE in AC is comparable to the rates reported in many studies in which the procedure took place during scheduled surgery. Accordingly, the occurrence of retained stone was not superior compared with scheduled surgery [10][11][12]19].…”

Single-stage procedure for the treatment of cholecysto-choledocolithiasis: a surgical procedures review

“…Trans-cystic clearance is the simplest approach and is recommended in the majority of cases. 55 It has clear indications regarding the size and number of stones and requires a good laparoscopic technique and a minimum organizational commitment. 56 It yields good results also in the case of acute cholecystitis.…”

“…In the various reported cases, the percentage of choledochotomy that is closed earlier than expected is about 30%–40% of the total. 55 However, as indicated by Cochrane in 2013, multiple randomized trials with long-term results are required in order to exclude complications such as biliary stricture or recurrence. 67 …”