Daniel Gomez1,2, Luis F Cabrera3,4,5, Ricardo Villarreal3,6,7, Mauricio Pedraza3,7, Jean Pulido3,7,8, Sánchez Sebastián3,7, Andrés Urrutia4, Andrés Mendoza2,7, Natan Zundel5,9,10. 1. Department of Advanced Laparoscopic Surgery, Military University, Bogota, Colombia. 2. Department of General Surgery, Centro Policlínico Olaya Bogota, Bogota, Colombia. 3. Department of General Surgery, Cobos Medical Center, El Bosque University, Bogota, Colombia. 4. Department of Medicine, Universidad Pedagógica y Tecnológica de Tunja, Tunja, Colombia. 5. Department of General Surgery, Fundación Santa Fe de Bogota, Bogota, Colombia. 6. Department of Gastrointestinal Surgery, Cobos Medical Center, Universidad El Bosque, Bogota, Colombia. 7. Department of Medicine, El Bosque University, Bogota, Colombia. 8. Medical Illustrator, Bogota, Colombia. 9. FIU Herbert Wertheim College of Medicine, Miami, Florida. 10. Minimally Invasive and Bariatric Surgery, FSFB, Bogota, Colombia.
Abstract
Background: Despite the effectiveness of laparoscopic common bile duct (CBD) surgery, no case series details the use and advantages of laparoscopic CBD exploration (LCBDE) without use of intraoperative cholangiography (IOC) in endoscopic retrograde cholangiopancreatography (ERCP) failure. Therefore, we present a case series regarding our success with LCBDE in managing CBD stones (CBDSs) using laparoscopic technique without IOC. Materials and Methods: We performed a descriptive retrospective observational study. Patients with CBDSs, alone or along with gallbladder stones, were treated through LCBDE with primary CBD closure after failed ERCP. Results: All patients underwent LCBDE with choledocotomy and primary duct closure. Patients with gallbladder stones underwent laparoscopic cholecystectomy (78%). All procedures were successful, and no conversions occurred. Surgery duration averaged 106 minutes. Intraoperative bleeding averaged 15 cc, and no mortalities occurred. No patients required additional surgery or intensive care unit admission. Hospitalization duration averaged 5 days. Conclusions: Therefore, a laparoscopic approach with primary CBD closure after failed ERCP for complex CBDSs is safe and effective.
Background: Despite the effectiveness of laparoscopic common bile duct (CBD) surgery, no case series details the use and advantages of laparoscopic CBD exploration (LCBDE) without use of intraoperative cholangiography (IOC) in endoscopic retrograde cholangiopancreatography (ERCP) failure. Therefore, we present a case series regarding our success with LCBDE in managing CBD stones (CBDSs) using laparoscopic technique without IOC. Materials and Methods: We performed a descriptive retrospective observational study. Patients with CBDSs, alone or along with gallbladder stones, were treated through LCBDE with primary CBD closure after failed ERCP. Results: All patients underwent LCBDE with choledocotomy and primary duct closure. Patients with gallbladder stones underwent laparoscopic cholecystectomy (78%). All procedures were successful, and no conversions occurred. Surgery duration averaged 106 minutes. Intraoperative bleeding averaged 15 cc, and no mortalities occurred. No patients required additional surgery or intensive care unit admission. Hospitalization duration averaged 5 days. Conclusions: Therefore, a laparoscopic approach with primary CBD closure after failed ERCP for complex CBDSs is safe and effective.
Entities:
Keywords:
bile duct surgery; laparoscopic common bile duct stone exploration; laparoscopy; magnetic resonance cholangiopancreatography and common bile duct stones; reconstruction