Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/1465
Title: Management of bile duct stones at cholecystectomy: an Australian single-centre experience over 2 years
Authors: Choi, Kihoon
Amarasena, Tehan
Hughes, Andrew
Shaw, Ian
Iswariah, Harish
Tam, Diana
Franz, Robert
Chandrasegaram, Manju
Issue Date: Mar-2021
Publisher: Springer New York LLC
Source: Choi K, Amarasena T, Hughes A, Shaw I, Iswariah H, Tam D, Franz R, Chandrasegaram M. Management of bile duct stones at cholecystectomy: an Australian single-centre experience over 2 years. Surg Endosc. 2021 Mar;35(3):1247-1253. doi: 10.1007/s00464-020-07495-7
Journal: Surgical endoscopy
Abstract: Bile duct stones with an intact gallbladder can be treated with either bile duct exploration at cholecystectomy or endoscopic retrograde cholangiopancreatography (ERCP) before or after cholecystectomy. The aim of this study was to evaluate the management of bile duct stones at cholecystectomy at our institution. We also aimed to identify risk factors for failure of ductal clearance in our series. A retrospective review of 690 laparoscopic cholecystectomies over a 2-year period was performed. Patients who underwent laparoscopic bile duct exploration formed the study population. Of 69 patients with suspected bile duct stones at cholecystectomy 67 (97%) patients underwent laparoscopic bile duct exploration upfront. Complete ductal clearance was achieved in 52 (78%) patients. Postoperative complications (10/67, 15%) included postoperative bleeding (2/67, 3%), bile leak (1/67, 1%), and superficial wound infection (1/67, 1%). There was no mortality. The mean operative time was 126 min and the median length of stay was 2 (1-4) days. A wider common bile duct (CBD) (≥ 8 mm) increased the risk of failed ductal clearance (OR 4.50; 95% confidence interval (CI) 1.15-19.23). This study found that laparoscopic bile duct exploration can effectively and safely treat bile duct stones suspected at cholecystectomy.
DOI: 10.1007/s00464-020-07495-7
Keywords: Cholangiopancreatography;Cholecystectomy;Common Bile Duct;Retrospective Studies;Risk Factors;Time Factors;Ductal clearance;Laparoscopic bile duct exploration;Transcystic exploration
Type: Article
Appears in Sites:Gold Coast Health Publications

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