scholarly journals Bile duct lavage and cholecystectomy: A single-stage operation for inspissated bile syndrome

2020 ◽  
Vol 53 (3) ◽  
pp. 109
Author(s):  
Rahul Gupta ◽  
ArunKumar Gupta ◽  
Ramesh Tanger ◽  
Anu Bhandari ◽  
RajKumar Gupta ◽  
...  
Keyword(s):  
Bile Duct ◽  
Single Stage ◽  
Duct Lavage

scholarly journals Abordaje laparoscópico sistemático de la coledocolitiasis

2021 ◽  
Vol 113 (1) ◽  
pp. 62-72
Author(s):  
Carlos M. Canullán ◽  
◽  
Enrique J. Petracchi ◽  
Nicolás Baglietto ◽  
Hugo I. Zandalazini ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Preoperative Diagnosis ◽  
Length Of Hospital Stay ◽  
Common Bile Duct Stones ◽  
Single Stage ◽  
Bile Duct Stones ◽  
Bile Duct Injuries ◽  
Transcystic Approach

Background: The prevalence of common bile duct stones associated with cholelithiasis increases with age and is about 15 % in the 8th decade of life but its management is still controversial. Some surgeons prefer the single-stage approach with laparoscopy while others suggest the two-stage management with preoperative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy. Objective: The aim of the present study was to evaluate the efficacy of feasibility of single-stage laparoscopic surgery in patients with cholelithiasis and choledocholithiasis. Material and methods: We conducted a retrospective study with prospectively collected data between July 2008 and July 2018. Results: Of 2447 laparoscopic cholecystectomies performed during the study period, 416 presented common bile duct stones. The global success of the transcystic approach to clear common bile duct stones was 81.2%, 70.4% in the cases with preoperative diagnosis of choledocholithiasis and 92.9% for other diagnoses. The rate of complications was 4% without deaths or bile duct injuries. Conclusion: Single-stage laparoscopic surgery is an efficient and safe approach based on the high global success of transcystic exploration. The preoperative diagnosis of choledocholithiasis reduces the efficacy of the procedure due to greater indication of choledocotomy, with complications and longer length of hospital stay.

scholarly journals How to choose the most appropriate technique for the single-stage treatment of cholecysto-choledocolithiasis?

2019 ◽  
Vol 7 (4) ◽  
pp. 258-262
Author(s):  
Aldo Bove ◽  
Paolo Panaccio ◽  
Raffaella di Renzo ◽  
Gino Palone ◽  
Marco Ricciardiello ◽  
...  
Keyword(s):  
Bile Duct ◽  
Surgical Technique ◽  
Operative Time ◽  
Single Stage ◽  
Surgical Time ◽  
Rendezvous Technique ◽  
Conversion Rates ◽  
Operative Complications ◽  
The One ◽  
Post Operative Complications

AbstractBackgroundWe utilized transcystic clearance and intra-operative papillotomy through a rendezvous technique for the treatment of cholecysto-choledocolithiasis. The goal of this study was to evaluate the reliability of pre-operative parameters to address the most suitable surgical procedure.MethodsA total of 180 patients affected by calculi of the gallbladder and bile duct underwent the single-stage treatment. According to several pre-operative parameters, 141 patients had to supposedly undergo transcystic clearance of the bile duct, while 39 patients had to be treated with the rendezvous technique. All patients were treated with the sequential procedure: first, we tried the transcystic procedure and, if there was a failure, we used a rendezvous technique. We prospectively analysed each group based on a series of variables such as sex, age, operative time, success rate of proposed treatment, conversion rate, post-operative complications and hospital stay.ResultsTranscystic clearance was successful in 134 out of 141 patients (95.0%), while 2 patients needed to undergo a laparo-endoscopy procedure (failure). Thirty-five out of 39 patients (89.7%) obtained common bile-duct (CBD) clearance through the rendezvous technique, while 1 patient obtained clean-up through the simple transcystic procedure (failure). Five out of 141 patients with transcystic clearance and 3 out of 39 patients with the rendezvous technique underwent laparotomy CBD clearance with conversion rates of 3.5% and 7.7%, respectively. Post-operative complications showed similar percentages for both procedures. However, the surgical time turned out to be longer for the rendezvous technique.ConclusionsThe one-stage procedure for the treatment of cholecysto-choledocolithiasis was possible in 94% of the cases utilizing a surgical technique selected according to the patient’s case history. The pre-operative parameters, such as jaundice, CBD diameters and stone diameters, have certified their reliability as good predictors of the most suitable procedure to follow.

Early versus Delayed Single-Stage Laparoscopic Eradication for Both Gallstones and Common Bile Duct Stones in Mild Acute Biliary Pancreatitis

2005 ◽  
Vol 71 (8) ◽  
pp. 682-686 ◽  
Author(s):  
John Griniatsos ◽  
Evangelos Karvounis ◽  
Alberto Isla
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Single Stage ◽  
Definitive Treatment ◽  
Morbidity Rate ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Laparoscopic Management ◽  
Significant Difference

Several studies addressed that preoperative endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct (CBD) clearance, followed by interval laparoscopic cholecystectomy (two-stage approach), constitutes the most common practice in cases of uncomplicated mild acute biliary pancreatitis. Between June 1998 and December 2002, 44 patients (35 females and 9 males with a median age of 62 years) suffering from uncomplicated mild acute biliary pancreatitis were treated in our unit. All patients were electively submitted to surgery after subsidence of the acute symptoms, and for definitive treatment we favored the single-stage laparoscopic management, avoiding preoperative ERCP. All patients underwent laparoscopic cholecystectomy plus fluoroscopic intraoperative cholangiogram (IOC). If filling defect(s) were detected in the IOC, a finding suggestive of concomitant choledocholithiasis, laparoscopic common bile duct exploration (LCBDE) was added in the same sitting. Twenty patients were operated upon within 2 weeks since the attack of the acute symptoms and constitute the early group (n = 20), whereas 24 patients underwent an operation later on and constitute the delay group (n = 24). We retrospectively compare the safety, effectiveness, and outcome after the single-stage laparoscopic management between the two groups of patients. Laparoscopic cholecystectomy alone constituted the definitive treatment in 38 patients, while an additional LCBDE was performed in the remaining 6 patients (14%), and all operations were achieved laparoscopically. There was no statistically significant difference between the groups in terms of operative time, incidence of concomitant choledocholithiasis, morbidity rate, and postoperative hospital stay. During the follow-up, none of the patients experienced recurrent pancreatitis. In uncomplicated mild acute biliary pancreatitis cases, a single-stage definitive laparoscopic management, avoiding preoperative ERCP, can be safely performed during the same admission, after the improvement of symptoms and local inflammation. Postoperative ERCP should be selectively used in patients in whom the single-stage method failed to resolve the problem.

Water jet cholecystectomy and common bile duct lavage under videolaparoscopic guidance

1995 ◽  
Vol 2 (3) ◽  
pp. 284-287 ◽  
Author(s):  
Roumen Dimitrov Penchev ◽  
Julian Emilov Losanoff ◽  
Kirien Tzvetanov Kjossev ◽  
Toma Petrov Pojarliev
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Water Jet ◽  
Duct Lavage

scholarly journals Single Stage Management of Concomitant Cholelithiasis and Choledocholithiasis

2017 ◽  
Vol 56 (205) ◽  
pp. 117-123
Author(s):  
Mukund Raj Joshi ◽  
Tanka Prasad Bohara ◽  
Shail Rupakheti ◽  
Deepak Raj Singh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone ◽  
Single Stage ◽  
Endoscopic Management ◽  
Stage Management ◽  
Endoscopic Method ◽  
Procedural Time

Introduction: Concomitant cholelithiasis and choledocholithiasis are commonly managed in two stage procedure, endoscopic management of common bile duct stone followed by laparoscopic cholecystectomy in different time and setting. We perform these two procedures in same sitting in operating room set up. We evaluated the procedure in terms of outcome, feasibility and complications. Methods: Prospective cross-sectional study carried out since April 2013 to August 2016 in all patients who had undergone single stage endoscopic and laparoscopic management of concomitant cholelithiasis and choledocholithiasis. Patient’s demography, procedural time for different procedure and procedure in total and post-operative complications were recorded and analyzed with suitable statistical methods. Results: Out of 50 cases enrolled, 2 patients were converted to open. Out of 48 patients, 3 needed re-attempt for completion. Majority were female 36 (72%), mean age was 39.48years. Mean common bile duct diameter and mean stone size was 11.43±2.63 cm and 7.99±2.01cm, respectively. Mean of total procedural time was 90.93± 33.68 minutes. In most of the cases, laparoscopic cholecystectomy performed first followed by endoscopic method (66.7%). Total procedural time was less in the patients who underwent laparoscopy first in comparison to endoscopy first. Clinically significant complications like cholangitis, pancreatitis and duodenal perforation occurred in 7 patients. Out of 4 patients who developed pancreatitis, one had severe acute pancreatitis requiring prolonged hospitalization. Conclusion: Single stage management of common bile duct and gall bladder stone by laparoscopic and endoscopic method is feasible in our setup with acceptable results. Endoscopic treatment of common bile duct stone if performed first, is associated with longer procedural time. Keywords: choledocholithiasis; cholelithiasis; endoscopic retrograde cholangiopancreatography; laparoscopic cholecystectomy.

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