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01-06-2011 | Letter-Reply

Laparoscopic bile duct exploration seems to be safe in higher-risk patients compared to endoscopic sphincterotomy and subsequent laparoscopic cholecystectomy, in a high-volume centre

Authors: H. Noble, E. Whitley, S. Norton, M. Thompson

Published in: Surgical Endoscopy | Issue 6/2011

Excerpt

We thank the authors [1] for their comments regarding our study [2]. We have indeed gone some way to show that bile duct exploration appears to be as safe as and more efficient than the two-stage alternative approach of endoscopic sphincterotomy followed by laparoscopic cholecystectomy in higher-risk patients fit enough to undergo surgery [3]. However, we recently presented some data at the AUGIS annual meeting that does suggest that there is a more profound reduction in postoperative pulmonary function in higher-risk patients following laparoscopic bile duct exploration than after laparoscopic cholecystectomy alone [4]. One might conclude, therefore, that higher-risk patients with significant lung disease might best be treated by sphincterotomy. …

Kilambi R, Bansal VK, Misra MC (2010) A study of preoperative factors associated with a poor outcome following laparoscopic bile duct exploration. Surg Endosc. doi:10.1007/s00464-010-1438-7

Noble H, Whitley E, Norton S, Thompson M (2011) A study of preoperative factors associated with a poor outcome following laparoscopic bile duct exploration. Surg Endosc 25:130–139PubMedCrossRef

Noble H, Tranter S, Chesworth T, Norton S, Thompson M (2009) A randomised, clinical trial to compare endoscopic sphincterotomy and subsequent laparoscopic cholecystectomy with primary laparoscopic bile duct exploration during cholecystectomy in higher risk patients with choledocholithiasis. J Laparoendosc Adv Surg Tech A 19(6):713–720PubMedCrossRef

Noble H, Barry J, Skyrme-Jones A, Norton SA, Thompson MH (2010) The cardio-pulmonary and inflammatory effects of laparoscopic and endoscopic treatment of bile duct stones in higher risk patients. BJS 97(5):42–43

Title: Laparoscopic bile duct exploration seems to be safe in higher-risk patients compared to endoscopic sphincterotomy and subsequent laparoscopic cholecystectomy, in a high-volume centre
Authors: H. Noble
E. Whitley
S. Norton
M. Thompson
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 6/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-011-1577-5

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Laparoscopic bile duct exploration seems to be safe in higher-risk patients compared to endoscopic sphincterotomy and subsequent laparoscopic cholecystectomy, in a high-volume centre

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

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