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World Journal of Surgery

Published in:

01-11-2005

Selective Intraoperative Cholangiography and Single-Stage Management of Common Bile Duct Stone in Laparoscopic Cholecystectomy

Authors: Shih-Chi Wu, MD, Feng-Chi Chen, MD, Chong-Jeh Lo, MD, FACS

Published in: World Journal of Surgery | Issue 11/2005

Abstract

Background

There are still debates and controversies in the detection and the management of common bile duct (CBD) stones in the era of laparoscopic cholecystectomy (LC). This prospective study was performed to evaluate a single-stage management of CBD stone during LC.

Methods

Between May 1998 and January 2000, 249 consecutive patients with gallstone and cholecystitis were enrolled in this study. The mean age was 52.5 ± 12.4 years. Male to female ratio was 106:143. All patients underwent abdominal sonography and the determination of the serum biochemical profile preoperatively. Patients presented with sepsis or with total bilirubin ≥ 6 ng/dL were excluded from the study.

Results

244 (98%) patients underwent LC and 5 (2%) patients were converted to open cholecystectomy. Intraoperative cholangiogram (IOC) was only performed in patients who fulfilled our predetermined criteria. Among 90 patients who had IOC, only 23 patients had CBD stones that were removed either by transcystic duct stone extraction (61%) or CBD exploration (39%). The additional procedures to remove CBD stone did not prolong the hospitalization. There were four wound infections and one cystic stump leakage. One patient developed CBD stone during the follow-up period up to 37 months.

Conclusions

Our study indicates that routine use of IOC during LC is not necessary. In addition, single-stage approach for the management of CBD stone during LC is feasible and should be considered by laparoscopic surgeons.

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Title: Selective Intraoperative Cholangiography and Single-Stage Management of Common Bile Duct Stone in Laparoscopic Cholecystectomy
Authors: Shih-Chi Wu, MD
Feng-Chi Chen, MD
Chong-Jeh Lo, MD, FACS
Publication date: 01-11-2005
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 11/2005
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-005-7694-3

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Selective Intraoperative Cholangiography and Single-Stage Management of Common Bile Duct Stone in Laparoscopic Cholecystectomy

Abstract

Background

Methods

Results

Conclusions

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