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An Alternative Approach of Choledocholithotomy via Laparoscopic Choledochotomy

An Alternative Approach of Choledocholithotomy via Laparoscopic Choledochotomy Abstract Objective: To evaluate the safety and feasibility of laparoscopic choledocholithotomy via choledochotomy for the treatment of choledocholithiasis. Design: A prospective series of 1332 consecutive patients who underwent laparoscopic cholecystectomies, with a mean follow-up of 21.2 months. Setting: University-affiliated referral center. Patients: Forty-three patients (3%) with documented common bile duct stones from January 1991 to February 1995. Interventions: Laparoscopic choledocholithotomy with choledochotomy and T tube drainage were performed in 40 patients. Postoperative endoscopic sphincterotomy after laparoscopic cholecystectomy was performed in three patients. Main Outcome Measures: Documented removal of common bile duct stones and procedure-related complications. Results: Laparoscopic choledocholithotomy via choledochotomy was successful in 35 (88%) of 40 patients in whom this procedure was attempted. The mean (±SD) operation time was 191.3±75.4 minutes, and the mean (±SD) length of postoperative stay was 10.4±2.7 days. Seven complications (18%) were recorded, including three major complications (8%) and two retained stones (5%). Conclusions: Laparoscopic choledocholithotomy via choledochotomy can be performed safely, without increasing the morbidity rate as compared with that of open choledocholithotomy. Thus, some of the advantages of minimally invasive surgery are preserved.(Arch Surg. 1996;131:407-411) References 1. Fink AS. Current dilemmas in management of common duct stones . Surg Endose . 1993;7:285-291.Crossref 2. Stimpson REJ, Way LW. Common duct stones . In: Moody FG, Carey LC, Jones RC, Kelly KA, Nahruold DL, Skinner DB, eds. Surgical Treatment of Digestive Diseases . St Louis, Mo: Mosby—Year Book Inc; 1986:306-322. 3. Jordan EJ. Choledocholithiasis . Curr Probl Surg . 1982;19:722-798.Crossref 4. Schirmer BD, Edge SB, Dix J, Hyser MJ, Hanks JB, Jones RS. Laparoscopic cholecystectomy . Ann Surg . 1991;213:665-677.Crossref 5. Peters JH, Ellison EC, Innes JT, et al. Safety and efficacy of laparoscopic cholecystectomy . Ann Surg . 1991;213:3-12.Crossref 6. Reddick EJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy . Am J Surg . 1990;160:485-487.Crossref 7. Voyles CR, Petro AB, Meena AL, Haick AJ, Koury AM. A practical approach to laparoscopic cholecystectomy . Am J Surg . 1991;161:365-370.Crossref 8. Cuschieri A, Dubois F, Mouiel J, et al. The European experience with laparoscopic cholecystectomy . Am J Surg . 1991;161:385-387.Crossref 9. Southern Surgeons Club. A prospective analysis of 1518 laparoscopic cholecystectomies . N Engl J Med . 1991;324:1073-1078.Crossref 10. Spaw AT, Reddick EJ, Olsen DO. Laparoscopic laser cholecystectomy: analysis of 500 procedures . Surg Laparosc Endosc . 1991;1:2-7. 11. Soper NJ. Laparoscopic cholecystectomy . Curr Probl Surg . 1991;28:583-655.Crossref 12. Hunter JG. Laparoscopic transcystic common bile duct exploration . Am J Surg . 1992;163:53-56.Crossref 13. Classen M, Demling L. Endoskopishe Sphinkterotomie der Papilla vateri und Steinextraktion aus dem Ductus choledochus . Dtsch Med Wochenschr . 1974; 99:496-497.Crossref 14. Kawai K, Akasaka Y, Murakami K, Tada M, Kohli Y, Nakajima M. Endoscopic sphincterotomy of the ampulla of vater . Gastrointest Endosc . 1974;20:148-151.Crossref 15. Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management . Gastrointest Endosc . 1991;37:383-393.Crossref 16. Leese T, Neoptolemos JP, Carr-Locke DL. Successes, failures, early complications and their management following endoscopic sphincterotomy: results in 394 consecutive patients from a single center . Br J Surg . 1985;72:215-219.Crossref 17. Pappas TN, Slimane TB, Brooks DC. 100 consecutive common duct explorations without mortality . Ann Surg . 1990;211:260-262. 18. Neoptolemos JP, Carr-Locke DL, Fossard DP. Prospective randomized study of preoperative endoscopic sphincterotomy versus surgery alone for common bile duct stones . BMJ . 1987;294:470-474.Crossref 19. Stain SC, Cohen H, Tsuishoysha M, Donovan AJ. Choledocholithiasis . Ann Surg . 1991;213:627-634.Crossref 20. Sackier JM, Berci G, Paz-Partlow M. Laparoscopic transcystic choledocholithotomy as an adjunct to laparoscopic cholecystectomy . Ann Surg . 1991;57: 323-326. 21. Petelin JB. Laparoscopic approach to common duct pathology . Surg Laparosc Endosc . 1991;1:33-41. 22. Hunter JG. Laparoscopic transcystic common duct exploration . Am J Surg . 1992;163:53-58.Crossref 23. Quattlebaum JK, Flandors HD. Laparoscopic treatment of common bile duct stones . Surg Laparosc Endosc . 1991;1:26-32. 24. Dion YM, Ratelle R, Morin J, Gravel D. Common bile duct exploration . Surg Laparosc Endosc . 1994;4:419-424.Crossref 25. Franklin ME Jr, Pharand D, Rosenthal D. Laparoscopic common bile duct exploration . Surg Laparosc Endosc . 1994;4:119-124.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

An Alternative Approach of Choledocholithotomy via Laparoscopic Choledochotomy

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References (35)

Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1996.01430160065012
Publisher site
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Abstract

Abstract Objective: To evaluate the safety and feasibility of laparoscopic choledocholithotomy via choledochotomy for the treatment of choledocholithiasis. Design: A prospective series of 1332 consecutive patients who underwent laparoscopic cholecystectomies, with a mean follow-up of 21.2 months. Setting: University-affiliated referral center. Patients: Forty-three patients (3%) with documented common bile duct stones from January 1991 to February 1995. Interventions: Laparoscopic choledocholithotomy with choledochotomy and T tube drainage were performed in 40 patients. Postoperative endoscopic sphincterotomy after laparoscopic cholecystectomy was performed in three patients. Main Outcome Measures: Documented removal of common bile duct stones and procedure-related complications. Results: Laparoscopic choledocholithotomy via choledochotomy was successful in 35 (88%) of 40 patients in whom this procedure was attempted. The mean (±SD) operation time was 191.3±75.4 minutes, and the mean (±SD) length of postoperative stay was 10.4±2.7 days. Seven complications (18%) were recorded, including three major complications (8%) and two retained stones (5%). Conclusions: Laparoscopic choledocholithotomy via choledochotomy can be performed safely, without increasing the morbidity rate as compared with that of open choledocholithotomy. Thus, some of the advantages of minimally invasive surgery are preserved.(Arch Surg. 1996;131:407-411) References 1. Fink AS. Current dilemmas in management of common duct stones . Surg Endose . 1993;7:285-291.Crossref 2. Stimpson REJ, Way LW. Common duct stones . In: Moody FG, Carey LC, Jones RC, Kelly KA, Nahruold DL, Skinner DB, eds. Surgical Treatment of Digestive Diseases . St Louis, Mo: Mosby—Year Book Inc; 1986:306-322. 3. Jordan EJ. Choledocholithiasis . Curr Probl Surg . 1982;19:722-798.Crossref 4. Schirmer BD, Edge SB, Dix J, Hyser MJ, Hanks JB, Jones RS. Laparoscopic cholecystectomy . Ann Surg . 1991;213:665-677.Crossref 5. Peters JH, Ellison EC, Innes JT, et al. Safety and efficacy of laparoscopic cholecystectomy . Ann Surg . 1991;213:3-12.Crossref 6. Reddick EJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy . Am J Surg . 1990;160:485-487.Crossref 7. Voyles CR, Petro AB, Meena AL, Haick AJ, Koury AM. A practical approach to laparoscopic cholecystectomy . Am J Surg . 1991;161:365-370.Crossref 8. Cuschieri A, Dubois F, Mouiel J, et al. The European experience with laparoscopic cholecystectomy . Am J Surg . 1991;161:385-387.Crossref 9. Southern Surgeons Club. A prospective analysis of 1518 laparoscopic cholecystectomies . N Engl J Med . 1991;324:1073-1078.Crossref 10. Spaw AT, Reddick EJ, Olsen DO. Laparoscopic laser cholecystectomy: analysis of 500 procedures . Surg Laparosc Endosc . 1991;1:2-7. 11. Soper NJ. Laparoscopic cholecystectomy . Curr Probl Surg . 1991;28:583-655.Crossref 12. Hunter JG. Laparoscopic transcystic common bile duct exploration . Am J Surg . 1992;163:53-56.Crossref 13. Classen M, Demling L. Endoskopishe Sphinkterotomie der Papilla vateri und Steinextraktion aus dem Ductus choledochus . Dtsch Med Wochenschr . 1974; 99:496-497.Crossref 14. Kawai K, Akasaka Y, Murakami K, Tada M, Kohli Y, Nakajima M. Endoscopic sphincterotomy of the ampulla of vater . Gastrointest Endosc . 1974;20:148-151.Crossref 15. Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management . Gastrointest Endosc . 1991;37:383-393.Crossref 16. Leese T, Neoptolemos JP, Carr-Locke DL. Successes, failures, early complications and their management following endoscopic sphincterotomy: results in 394 consecutive patients from a single center . Br J Surg . 1985;72:215-219.Crossref 17. Pappas TN, Slimane TB, Brooks DC. 100 consecutive common duct explorations without mortality . Ann Surg . 1990;211:260-262. 18. Neoptolemos JP, Carr-Locke DL, Fossard DP. Prospective randomized study of preoperative endoscopic sphincterotomy versus surgery alone for common bile duct stones . BMJ . 1987;294:470-474.Crossref 19. Stain SC, Cohen H, Tsuishoysha M, Donovan AJ. Choledocholithiasis . Ann Surg . 1991;213:627-634.Crossref 20. Sackier JM, Berci G, Paz-Partlow M. Laparoscopic transcystic choledocholithotomy as an adjunct to laparoscopic cholecystectomy . Ann Surg . 1991;57: 323-326. 21. Petelin JB. Laparoscopic approach to common duct pathology . Surg Laparosc Endosc . 1991;1:33-41. 22. Hunter JG. Laparoscopic transcystic common duct exploration . Am J Surg . 1992;163:53-58.Crossref 23. Quattlebaum JK, Flandors HD. Laparoscopic treatment of common bile duct stones . Surg Laparosc Endosc . 1991;1:26-32. 24. Dion YM, Ratelle R, Morin J, Gravel D. Common bile duct exploration . Surg Laparosc Endosc . 1994;4:419-424.Crossref 25. Franklin ME Jr, Pharand D, Rosenthal D. Laparoscopic common bile duct exploration . Surg Laparosc Endosc . 1994;4:119-124.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Apr 1, 1996

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