10 years of laparoscopic common bile duct exploration: A single tertiary institution experience - 16/04/19
, Yuxuan Wang, Martin Schreiber, Laszlo KiralyAbstract |
Introduction |
Laparoscopic common bile duct exploration (LCBDE-LC) or ERCP plus laparoscopic cholecystectomy (ERCP-LC) represent minimally invasive choledocholithiasis treatments. We hypothesized that LCBDE-LC has a shorter length of stay (LOS) and lower charges than ERCP-LC.
Methods |
Charts were reviewed for all LCBDE-LC or ERCP-LC for choledocholithiasis from 2007 to 2017. Exclusions included cholangitis, concomitant procedures, or history of Roux-en-Y or biliary surgery. Groups were determined via intention-to-treat with LCBDE-LC or ERCP-LC.
Results |
281 subjects were identified; 157 met inclusion criteria. 89 (56%) were in the LCBDE-LC group. There were no differences in age, sex, or ASA. LOS was shorter for LCBDE-LC (3.1 vs 4.4 days, p < 0.01) although total anesthesia time was longer (292 vs 262 min, p = 0.01). There was no difference in total charges ($44,412 vs $51,353, p = 0.08). Thirty (33%) LCBDE-LC were aborted due to challenges passing the dilator or scope (33%) or clearing stones (30%). Two ERCP-LC cases required post-procedure LCBDE.
Conclusion |
LCBDE-LC resulted in shorter LOS but had a high failure rate. Further research is needed to predict which cases suit each modality.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Laparoscopic common bile duct exploration had a shorter length of stay compared to ERCP for choledocholithiasis. |
• | The success rate of LCBDE-LC in this sample was 66%. |
• | Total anesthesia time was longer for LCBDE-LC but there was no significant difference in total charges was seen between the two groups. |
• | The most common reasons for unsuccessful LCBDE-LC were challenges passing the dilator or scope, or retained stones. |
Keywords : Choledocholithiasis, Common bile duct exploration, Laparoscopic cholecystectomy, Endoscopic retrograde cholangiopancreatography
Plan
Vol 217 - N° 5
P. 970-973 - mai 2019 Retour au numéro
Article précédent
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