A 23 year experience with laparoscopic common bile duct exploration

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• 作者：Silvia Quaresima¹ ; ^{s.quaresima@hotmail.com} ; Andrea Balla¹ ; Mario Guerrieri² ; Roberto Campagnacci² ; Emanuele Lezoche¹ ; Alessandro M. Paganini¹
• 刊名：HPB
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：19
• 期：1
• 页码：29-35
• 全文大小：362 K
• 卷排序：19

文摘

Laparoscopic common bile duct exploration (LCBDE) during laparoscopic cholecystectomy (LC) is as effective as two-stage endo-laparoscopic treatment, but with shorter hospital stay, lower cost and recurrent stone rate. Aim of this paper was to report the authors’ experience with LCBDE during LC.MethodsA retrospective analysis of patients who underwent LCBDE for ductal stones was performed. Recurrent stones were defined as CBD stones detected beyond 6 months from the procedure. Postoperative biliary stricture was defined as a symptomatic reduction of CBD diameter.ResultsOut of 3444 patients who underwent LC, 384 (11%) had CBD stones treated by trans-cystic duct exploration [214 (6%) patients, TCD-CBDE] or choledochotomy [170 (5%) patients, C-CBDE]. For TCD-CBDE and C-CBDE, mean operative time was 127 ± 69 and 191 ± 74 min, respectively. Major morbidity rate was 3% (n = 6) in TCD-CBDE and 6% (n = 11) in C-CBDE. The incidence of residual stones was 5% (n = 20) and complete ductal clearance rate was 95% (n = 364). After long-term follow-up (mean 189 ± 105 months) the recurrent stone rate was 2%.DiscussionIn expert centers, LCBDE during LC is safe and effective with low short and long term morbidity rates.