Jun Suh Lee1, Young Chul Yoon2. 1. Department of Surgery, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Dongsu-ro 56, Bupyung-gu, Incheon, Gyeonggi-do, 404-834, Republic of Korea. 2. Department of Surgery, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Dongsu-ro 56, Bupyung-gu, Incheon, Gyeonggi-do, 404-834, Republic of Korea. k07yyc@catholic.ac.kr.
Abstract
BACKGROUND: The treatment of concomitant gallbladder (GB) and common bile duct (CBD) stones is still variable, without a standard treatment protocol. Endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy is widely being used, but laparoscopic common bile duct exploration (LCBDE) is also being widely performed. We present our method of LCBDE, with anterograde insertion of an endobiliary stent and primary closure of the CBD using unidirectional barbed suture. METHODS: From November 2013 to March 2015, LCBDE was performed on 15 consecutive patients. Chart review was performed to analyze demographic data and perioperative data. After dissection of the GB from the liver bed, the CBD is dissected and a choledochotomy is made. A choledochoscope is inserted in the CBD, and using various methods, CBD stones are extracted. An endobiliary stent is inserted, and the CBD is closed using unidirectional barbed sutures. RESULTS: Mean age of the patients was 64.7 ± 12.5 years. Of the 15 patients, six patients (40 %) were male and nine patients (60 %) were female. The average operation time and postoperative stay were 90.7 ± 32.5 min and 4.3 ± 1.2 days, respectively. There were no significant complications such as postoperative bleeding, bile leakage, or biliary stricture. CONCLUSIONS: LCBDE using barbed V-Loc suture with insertion of endobiliary stent is a safe, feasible treatment modality that is easily reproducible. Our preliminary results show a zero complication rate, with an acceptable operation time.
BACKGROUND: The treatment of concomitant gallbladder (GB) and common bile duct (CBD) stones is still variable, without a standard treatment protocol. Endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy is widely being used, but laparoscopic common bile duct exploration (LCBDE) is also being widely performed. We present our method of LCBDE, with anterograde insertion of an endobiliary stent and primary closure of the CBD using unidirectional barbed suture. METHODS: From November 2013 to March 2015, LCBDE was performed on 15 consecutive patients. Chart review was performed to analyze demographic data and perioperative data. After dissection of the GB from the liver bed, the CBD is dissected and a choledochotomy is made. A choledochoscope is inserted in the CBD, and using various methods, CBD stones are extracted. An endobiliary stent is inserted, and the CBD is closed using unidirectional barbed sutures. RESULTS: Mean age of the patients was 64.7 ± 12.5 years. Of the 15 patients, six patients (40 %) were male and nine patients (60 %) were female. The average operation time and postoperative stay were 90.7 ± 32.5 min and 4.3 ± 1.2 days, respectively. There were no significant complications such as postoperative bleeding, bile leakage, or biliary stricture. CONCLUSIONS:LCBDE using barbed V-Loc suture with insertion of endobiliary stent is a safe, feasible treatment modality that is easily reproducible. Our preliminary results show a zero complication rate, with an acceptable operation time.
Entities:
Keywords:
Choledocholithiasis; Common bile duct diseases; Laparoscopy
Authors: F U Malya; O Karatepe; H Bektasoglu; G Cipe; S Bozkurt; M Hasbahceci; G Ozturk; K Yildiz; M Muslumanoglu Journal: Hepatogastroenterology Date: 2014 Mar-Apr
Authors: Marco Milone; Matteo Nicola Dario Di Minno; Giuseppe Galloro; Paola Maietta; Paolo Bianco; Francesco Milone; Mario Musella Journal: J Laparoendosc Adv Surg Tech A Date: 2013-07-16 Impact factor: 1.878