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Comparative Study
. 2010 Apr-Jun;14(2):246-50.
doi: 10.4293/108680810X12785289144395.

Laparoscopic common bile duct exploration in patients with gallstones and choledocholithiasis

Aléxis Sanchez  1 , Omaira Rodriguez, Omar Bellorín, Renata Sánchez, Gustavo Benítez
Affiliations
Comparative Study

Laparoscopic common bile duct exploration in patients with gallstones and choledocholithiasis

Aléxis Sanchez et al. JSLS. 2010 Apr-Jun.

Abstract

Objectives: To compare the effectiveness of laparoscopic common bile duct exploration in patients with failed endoscopic retrograde cholangiopancreatography (ERCP).

Methods: This is a descriptive, comparative study. Patients with an indication of common bile duct exploration between February 2005 and October 2008 were included. We studied 2 groups: Group A: patients with failed ERCP who underwent LCBDE plus LC. Group B: patients with common bile duct stones managed with the 1-step approach (LCBDE + LC) with no prior ERCP.

Results: Twenty-five patients were included. Group A: 9 patients, group B: 16 patients. Success rate, operative time, and hospital stay were as follows: group A 66% vs group B 87.5%; group A 187 minutes vs 106 minutes; group A 4.5 days vs 2.3 days; respectively.

Conclusion: Patients with failed ERCP should be considered as high-complex cases in which the laparoscopic procedure success rate decreases, and the conversion rate increases considerably.

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Figures

Figure 1.
Figure 1.
Intraoperative cholangiography showing dilated common bile duct and multiple stones.
Figure 2.
Figure 2.
Common bile duct stone under direct vision of choledochoscope.
Figure 3.
Figure 3.
Choledochotomy must match the size of the larger stone.
See this image and copyright information in PMC

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