BACKGROUND: Several techniques of laparoscopic bile duct exploration and intraoperative endoscopic sphincterotomy (ES) have been developed to treat patients with common bile duct (CBD) stones in one session and avoid the complications of ES. With all these options available, very few randomized controlled trials (RCTs) have been undertaken. This review analyzes those studies. METHODS: We searched PubMed. Four RCTs and a Cochran Database Systematic Review were found. RESULTS: Two RCTs compared preoperative ES and laparoscopic CBD exploration (E) for known CBD stones. Laparoscopic CBDE had shorter length of hospitalization. Two RCTs compared immediate and delayed treatment and found that length of stay was less with laparoscopic CBDE, but clearance rates and morbidity/mortality were similar. CONCLUSIONS: Studies suggest that CBD stones discovered at the time of cholecystectomy are best treated during the same operation. The transcystic approach is safest if applicable. Individual surgeons must be aware of their own capabilities and those of the available endoscopists and perform the safest technique.
BACKGROUND: Several techniques of laparoscopic bile duct exploration and intraoperative endoscopic sphincterotomy (ES) have been developed to treat patients with common bile duct (CBD) stones in one session and avoid the complications of ES. With all these options available, very few randomized controlled trials (RCTs) have been undertaken. This review analyzes those studies. METHODS: We searched PubMed. Four RCTs and a Cochran Database Systematic Review were found. RESULTS: Two RCTs compared preoperative ES and laparoscopic CBD exploration (E) for known CBD stones. Laparoscopic CBDE had shorter length of hospitalization. Two RCTs compared immediate and delayed treatment and found that length of stay was less with laparoscopic CBDE, but clearance rates and morbidity/mortality were similar. CONCLUSIONS: Studies suggest that CBD stones discovered at the time of cholecystectomy are best treated during the same operation. The transcystic approach is safest if applicable. Individual surgeons must be aware of their own capabilities and those of the available endoscopists and perform the safest technique.
Authors: A Cuschieri; E Lezoche; M Morino; E Croce; A Lacy; J Toouli; A Faggioni; V M Ribeiro; J Jakimowicz; J Visa; G B Hanna Journal: Surg Endosc Date: 1999-10 Impact factor: 4.584
Authors: Mehmet Odabasi; Mehmet Kamil Yildiz; Haci Hasan Abuoglu; Cengiz Eris; Erkan Ozkan; Emre Gunay; Ali Aktekin; Ma Tolga Muftuoglu Journal: World J Gastrointest Endosc Date: 2013-11-16
Authors: A Bove; G Bongarzoni; G Palone; R M Di Renzo; E M Calisesi; L Corradetti; M Di Nicola; L Corbellini Journal: Surg Endosc Date: 2009-03-05 Impact factor: 4.584
Authors: R Campagnacci; A Baldoni; M Baldarelli; M Rimini; A De Sanctis; M Di Emiddio; M Guerrieri Journal: Surg Endosc Date: 2009-07-08 Impact factor: 4.584