Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 cases

Background: The optimal treatment for choledocholithiasis (CLT) is currently the subject of debate, as there is no clear evidence that a two-step (endoscopic plus surgical) approach is superior to a one-step surgical procedure. Materials and methods: We analyzed the results obtained from 101 consecu...

Descripción completa

Detalles Bibliográficos
Autores: Martín Arnau, Belén|||0000-0002-5841-4180, Rodríguez Blanco, Manuel|||0000-0002-5518-0083, Molina Santos, Victor|||0000-0003-3631-0062, Fueyo, A.R., Moral, Antonio|||0000-0001-5551-0145, Sánchez-Cabús, Santiago|||0000-0002-0575-1466
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:270182
Acceso en línea:https://ddd.uab.cat/record/270182
https://dx.doi.org/urn:doi:10.5005/jp-journals-10033-1447
Access Level:acceso abierto
Palabra clave:Cholangiopancreatography endoscopic retrograde
Choledocholithiasis
Laparoscopic cholecystectomy
Laparoscopic common bile duct exploration
id ES_0fce968ad0897b4d885787d8385cd12d
oai_identifier_str oai:ddd.uab.cat:270182
network_acronym_str ES
network_name_str España
repository_id_str
spelling Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 casesMartín Arnau, Belén|||0000-0002-5841-4180Rodríguez Blanco, Manuel|||0000-0002-5518-0083Molina Santos, Victor|||0000-0003-3631-0062Fueyo, A.R.Moral, Antonio|||0000-0001-5551-0145Sánchez-Cabús, Santiago|||0000-0002-0575-1466Cholangiopancreatography endoscopic retrogradeCholedocholithiasisLaparoscopic cholecystectomyLaparoscopic common bile duct explorationBackground: The optimal treatment for choledocholithiasis (CLT) is currently the subject of debate, as there is no clear evidence that a two-step (endoscopic plus surgical) approach is superior to a one-step surgical procedure. Materials and methods: We analyzed the results obtained from 101 consecutive patients diagnosed with CLT using magnetic resonance cholangiopancreatography (MRCP) or computed tomography (CT) scan undergoing cholecystectomy and laparoscopic exploration of the bile duct, carried out at our center between 2006 and 2019. In this analysis, special emphasis was made on the permanent resolution of the CLT and the associated complications. Results: The mean surgical time was 142 ± 36.7 minutes. In patients with a CLT diagnostic test more than 7 days previously, the presence of CLT was checked using intraoperative cholangiography (IOC), which was negative in 25% of patients, while in the rest, a primary exploration was performed using a choledochoscope via choledochotomy in 82.2% of patients and via the transcystic approach in two cases. A T-tube drain was inserted in 18.9% of patients. The conversion rate was 0.9%, due to a technical difficulty in removing the CLT in one patient. The laparoscopic approach treated the CLT permanently in 97/101 cases (96%), while four patients (3.9%) required postoperative endoscopic retrograde cholangiopancreatography (ERCP) due to residual cholelithiasis. A total of 15.8% of patients experienced a postoperative biliary fistula, which was resolved using conservative management in 86.7% of them, while two patients required surgical treatment and insertion of a percutaneous drain, respectively. The average postoperative stay duration was 6.5 ± 7.3 days. None of the patients showed signs of biliary stricture in the long-term postoperative follow-up. Conclusion: In our experience, the laparoscopic approach for one-step elective treatment of CLT is a safe option, with a very small number of complications and satisfactory short-and long-term results. Furthermore, despite preoperative identification of CLT, it helped to avoid unnecessary exploration of the bile duct in 25% of patients. 22021-01-0120212021-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/270182https://dx.doi.org/urn:doi:10.5005/jp-journals-10033-1447reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2701822026-06-06T12:50:31Z
dc.title.none.fl_str_mv Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 cases
title Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 cases
spellingShingle Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 cases
Martín Arnau, Belén|||0000-0002-5841-4180
Cholangiopancreatography endoscopic retrograde
Choledocholithiasis
Laparoscopic cholecystectomy
Laparoscopic common bile duct exploration
title_short Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 cases
title_full Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 cases
title_fullStr Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 cases
title_full_unstemmed Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 cases
title_sort Results obtained with the laparoscopic approach to the bile duct for the treatment of choledocholithiasis in 101 cases
dc.creator.none.fl_str_mv Martín Arnau, Belén|||0000-0002-5841-4180
Rodríguez Blanco, Manuel|||0000-0002-5518-0083
Molina Santos, Victor|||0000-0003-3631-0062
Fueyo, A.R.
Moral, Antonio|||0000-0001-5551-0145
Sánchez-Cabús, Santiago|||0000-0002-0575-1466
author Martín Arnau, Belén|||0000-0002-5841-4180
author_facet Martín Arnau, Belén|||0000-0002-5841-4180
Rodríguez Blanco, Manuel|||0000-0002-5518-0083
Molina Santos, Victor|||0000-0003-3631-0062
Fueyo, A.R.
Moral, Antonio|||0000-0001-5551-0145
Sánchez-Cabús, Santiago|||0000-0002-0575-1466
author_role author
author2 Rodríguez Blanco, Manuel|||0000-0002-5518-0083
Molina Santos, Victor|||0000-0003-3631-0062
Fueyo, A.R.
Moral, Antonio|||0000-0001-5551-0145
Sánchez-Cabús, Santiago|||0000-0002-0575-1466
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Cholangiopancreatography endoscopic retrograde
Choledocholithiasis
Laparoscopic cholecystectomy
Laparoscopic common bile duct exploration
topic Cholangiopancreatography endoscopic retrograde
Choledocholithiasis
Laparoscopic cholecystectomy
Laparoscopic common bile duct exploration
description Background: The optimal treatment for choledocholithiasis (CLT) is currently the subject of debate, as there is no clear evidence that a two-step (endoscopic plus surgical) approach is superior to a one-step surgical procedure. Materials and methods: We analyzed the results obtained from 101 consecutive patients diagnosed with CLT using magnetic resonance cholangiopancreatography (MRCP) or computed tomography (CT) scan undergoing cholecystectomy and laparoscopic exploration of the bile duct, carried out at our center between 2006 and 2019. In this analysis, special emphasis was made on the permanent resolution of the CLT and the associated complications. Results: The mean surgical time was 142 ± 36.7 minutes. In patients with a CLT diagnostic test more than 7 days previously, the presence of CLT was checked using intraoperative cholangiography (IOC), which was negative in 25% of patients, while in the rest, a primary exploration was performed using a choledochoscope via choledochotomy in 82.2% of patients and via the transcystic approach in two cases. A T-tube drain was inserted in 18.9% of patients. The conversion rate was 0.9%, due to a technical difficulty in removing the CLT in one patient. The laparoscopic approach treated the CLT permanently in 97/101 cases (96%), while four patients (3.9%) required postoperative endoscopic retrograde cholangiopancreatography (ERCP) due to residual cholelithiasis. A total of 15.8% of patients experienced a postoperative biliary fistula, which was resolved using conservative management in 86.7% of them, while two patients required surgical treatment and insertion of a percutaneous drain, respectively. The average postoperative stay duration was 6.5 ± 7.3 days. None of the patients showed signs of biliary stricture in the long-term postoperative follow-up. Conclusion: In our experience, the laparoscopic approach for one-step elective treatment of CLT is a safe option, with a very small number of complications and satisfactory short-and long-term results. Furthermore, despite preoperative identification of CLT, it helped to avoid unnecessary exploration of the bile duct in 25% of patients.
publishDate 2021
dc.date.none.fl_str_mv 2
2021-01-01
2021
2021-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/270182
https://dx.doi.org/urn:doi:10.5005/jp-journals-10033-1447
url https://ddd.uab.cat/record/270182
https://dx.doi.org/urn:doi:10.5005/jp-journals-10033-1447
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869403474913918976
score 15,301603

Similares en LA Referencia