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Surgical Endoscopy

Published in:

01-05-2004 | Original article

Laparoscopic management of common bile duct stones

Authors: S. Ebner, J. Rechner, S. Beller, K. Erhart, F. M. Riegler, G. Szinicz

Published in: Surgical Endoscopy | Issue 5/2004

Abstract

Background

While laparoscopic cholecystectomy is widely accepted for therapy of cholecystolithiasis, controversy still exists concerning the management of common bile duct stones. Besides preoperative endoscopic papillotomy followed by laparoscopic cholecystectomy and open common bile duct surgery, management of common bile duct stones can be conducted by laparoscopy, if respective experience is available.

Method

During laparoscopic cholecystectomy a cholangiography via the cystic duct is routinely performed. If bile duct stones are detected they are retrieved via the cystic duct or via incision of the common bile duct by insertion of a Fogarty catheter or Dormia basket. Exclusion criteria against simultaneous laparoscopic management include suspicion of malignancy, severe pancreatitis, or cholangitis.

Results

From November 1991 to March 2002, 200 patients primarily underwent laparoscopic therapy of bile duct stones. Retrieval was performed via cystic duct and common bile duct incision in 115 and 85 cases, respectively. Complete removal was achieved in 91%; complication rate and mortality was 7% and 0.5%, respectively. During the same period primary endoscopic papillotomy was necessary in 40 patients because of the above contraindications.

Conclusions

When correct indications and surgical expertise are observed, simultaneous laparoscopic management of common bile duct stones represents a safe and minimally invasive alternative to a two-procedure approach.

Berthou, JC, Drouard, F, Charbonneau, P, Moussalier, K 1998Evaluation of laparoscopic management of common bile duct stones in 220 patients.Surg Endosc121622CrossRefPubMed

Boeckl, O, Sungler, P, Heinerman, PM, Lexer, G 1994Choledocholithiasis—therapeutical splitting.Chirurgie65424429

Capelluto, E, Barrat, C, Catheline, JM, Champault, G 1999Systematic peroperative cholangiography during laparoscopic cholecystectomy.Chirurgie124536541PubMed

Coppola, R, Riccioni, ME, Ciletti, S, Cosentino, L, Coco, C, Magistrelli, P, Picciocchi, A 1997Analysis of complications of endoscopic sphincterotomy for biliary stones in a consecutive series of 546 patients.Surg Endosc11129132CrossRefPubMed

Costamagna, G, Tringali, A, Shak, SK, Mutignani, M, Zuccala, G, Perri, V 2002Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence.Endoscopy34273279CrossRefPubMed

Cuschieri, A, Lezoche, E, Morino, M, Croce, E, Lacy, A, Toouli, J, Faggioni, A, Ribeiro, VM, Jakimowicz, J, Visa, J, Hanna, GB 1999E.A.E.S. multicenter prospective randomized trial comparing two-stage vs single-stage management of patients with gallstone disease and ductal calculi.Surg Endosc13952957CrossRefPubMed

Dorman, JP, Franklin ME, Jr, Glass, JL 1998Laparoscopic common bile duct exploration by choledochotomy.An effective and efficient method of treatment of choledocholithiasis. Surg Endosc12926928CrossRef

E.A.E.S.1998Diagnosis and treatment of common bile duct stones (CBDS). Results of a consensus development conference. Scientific Committee of the European Association for Endoscopic Surgery (E.A.E.S.).Surg Endosc12856864CrossRefPubMed

Hammarstrom, LE, Stridbeck, H, Ihse, I 1996Long-term follow-up after endoscopic treatment of bile duct calculi in cholecystectomized patients.World J Surg20272276CrossRefPubMed

10.

Heili, MJ, Wintz, NK, Fowler, DL 1999Choledocholithiasis: endoscopic versus laparoscopic management.Am Surg65135138PubMed

11.

Heinerman, PM, Boeckl, O, Pimpl, W 1989Selective ERCP and preoperative stone removal in bile duct surgery.Ann Surg209267272PubMed

12.

Huttl, TP, Hrdina, CH, Geiger, TK, Meyer, G, Schildberg, FW, Kramling, HJ 2002Management of common bile duct stones. Results of a nationwide survey with analysis of 8433 common bile duct explorations in Germany.Zentralbl Chir127282288CrossRefPubMed

13.

Kramling, HJ, Lange, V, Heberer, G 1993Current status of gallstone surgery in Germany. Results of a survey and retrospective analysis of 27,403 interventions—open vs. laparoscopic surgery.Chirurgie64295302

14.

Lezoche, E, Paganini, AM 2000Technical considerations and laparoscopic bile duct exploration: transcystic and choledochotomy.Semin Laparosc Surg7262278CrossRefPubMed

15.

Ludwig, K, Koeckerling, F, Hohenberger, W, Lorenz, D 2001Surgical therapy in cholecysto-/choledocholithiasis. Results of a Germany-wide questionnaire sent to 859 clinics with 123,090 cases of cholecystectomy.Chirurgie7211711178CrossRef

16.

Ludwig, K, Bernhardt, J, Steffen, H, Lorenz, D 2002Contribution of intraoperative cholangiography to incidence and outcome of common bile duct injuries during laparoscopic cholecystectomy.Surg Endosc1610981104CrossRefPubMed

17.

Millat, B, Atger, J, Deleuze, A, Briandet, H, Fingerhut, A, Guillon, F, Marrel, E, Seguin, C, Soulier, P 1997Laparoscopic treatment for choledocholithiasis: a prospective evaluation in 247 consecutive unselected patients.Hepatogastroenterology442834PubMed

18.

Neoptolemos, JP, Carr-Locke, DL, Fossard, DP 1987Prospective randomised study of preoperative endoscopic sphinkterotomy versus surgery alone for common bile duct stones.Br Med J234470477

19.

Paganini, AM, Feliciotti, F, Guerrieri, M, Tamburini, A, Campagnacci, R, Lezoche, E 2002Laparoscopic cholecystectomy and common bile duct exploration are safe for older patients.Surg Endosc1613021308CrossRefPubMed

20.

Pereira-Lima, JC, Jakobs, R, Winter, UH, Benz, C, Martin, WR, Adamek, HE, Riemann, JF 1998Long-term results (7 to 10 years) of endoscopic papillotomy for choledocholithiasis. Multivariate analysis of prognostic factors for the recurrence of biliary symptoms.Gastrointest Endosc48457464PubMed

21.

Pereira-Lima, JC, Rynkowski, CB, Rhoden, EL 2001Endoscopic treatment of choledocholithiasis in the era of laparoscopic cholecystectomy: prospective analysis of 386 patients.Hepatogastroenterology4812711274PubMed

22.

Pitt, HA 1993Role of open choledochotomy in the treatment of choledocholithiasis.Am J Surg165483486PubMed

23.

Rechner, J, Beller, S, Zerz, A, Szinicz, G 1996Double balloon catheter for facilitating (laparoscopic) choledochus drainage.Chirurg6712661269CrossRefPubMed

24.

Rhodes, M, Sussmann, L, Cohen, L, Lewis, MP 1998Randomised trial of laparoscopic exploration of common bile duct versus postoperative endoscopic retrograde cholangiography for common bile duct stones.Lancet351159161PubMed

25.

Riciardi, R, Islam, S, Canete, JJ, Arcand, PL, Stoker, ME 2003Effectiveness and long-term results of laparoscopic common bile duct exploration.Surg Endosc171922CrossRefPubMed

26.

SAGES, 1994Guidelines for the clinical application of laparoscopic biliary tract surgery.Surg Endosc814571458PubMed

27.

Sivak MV, Jr 1989Endoscopic management of bile duct stones.Am J Surg158228240PubMed

28.

Soehendra, N, Seifert, H, Thonke, F, Seitz, U, Wang, YG 1994Endoscopic techniques in therapy of choledocholithiasis.Chirurgie65413417

29.

Tokumura, H, Umezawa, A, Cao, H, Sakamoto, N, Imaoka, Y, Ouchi, A, Yamamoto, K 2002Laparoscopic management of common bile duct stones: transcystic approach and choledochotomy.J Hepatobil Pancreat Surg9206212CrossRef

30.

Tranter, SE, Thompson, MH 2002Comparison of endoscopic sphincterotomy and laparoscopic exploration of the common bile duct.Br J Surg8914951504CrossRefPubMed

31.

Wills, VL, Gibson, K, Karihaloot, C, Jorgensen, JO 2002Complications of biliary T-tubes after choledochotomy.ANZ J Surg72177180CrossRefPubMed

Title: Laparoscopic management of common bile duct stones
Authors: S. Ebner
J. Rechner
S. Beller
K. Erhart
F. M. Riegler
G. Szinicz
Publication date: 01-05-2004
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 5/2004
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-003-9029-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic management of common bile duct stones

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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