Single-stage laparoscopic treatment of gallstones and common bile duct (CBD) stones is now challenging the traditional two-stage endo/laparoscopic approach. Many surgeons are reluctant to adopt this procedure because they believe this operation to be difficult and time-consuming. The aim of this report is to describe the technical details of the procedure and to demonstrate its effectiveness in a large series of unselected, consecutive patients. CBD stones were demonstrated in 301 unselected patients out of 2,894 undergoing laparoscopic cholecystectomy (10.4%) and were treated laparoscopically in 297 (98.6%), by the transcystic route in 185 patients (62.2%) and after choledochotomy in 112 patients (37.8%). Mean operative time was 119.2 minutes. Major complications were bile leakage (5 patients) and hemoperitoneum (4 patients) (3%). Retained CBD stones were observed in 14 patients (4.7%) and mortality in 1 high-risk patient (0.3%). Recurrent ductal stones occurred in 5 cases (1.6%) with dilated bile ducts, all after laparoscopic choledochotomy. Single-stage laparoscopic treatment of gallstones and CBD stones treats 2 problems during the same operation, avoids the additive complications of a second procedure (endoscopic sphincterotomy), and reduces hospital stay and costs. Laparoscopic management of ductal stones during laparoscopic cholecystectomy is the new "gold standard" for the treatment of gallstones and CBD stones. Copyright © 2000 by W.B. Saunders Company.

Technical considerations and laparoscopic bile duct exploration. Transcystic and choledochotomy / Lezoche, Emanuele; Paganini, Alessandro M.. - In: SEMINARS IN LAPAROSCOPIC SURGERY. - ISSN 1071-5517. - 7:4(2000), pp. 262-278. [10.1053/slas.2000.19788]

Technical considerations and laparoscopic bile duct exploration. Transcystic and choledochotomy

Lezoche, Emanuele;Paganini, Alessandro M.
Ultimo
2000

Abstract

Single-stage laparoscopic treatment of gallstones and common bile duct (CBD) stones is now challenging the traditional two-stage endo/laparoscopic approach. Many surgeons are reluctant to adopt this procedure because they believe this operation to be difficult and time-consuming. The aim of this report is to describe the technical details of the procedure and to demonstrate its effectiveness in a large series of unselected, consecutive patients. CBD stones were demonstrated in 301 unselected patients out of 2,894 undergoing laparoscopic cholecystectomy (10.4%) and were treated laparoscopically in 297 (98.6%), by the transcystic route in 185 patients (62.2%) and after choledochotomy in 112 patients (37.8%). Mean operative time was 119.2 minutes. Major complications were bile leakage (5 patients) and hemoperitoneum (4 patients) (3%). Retained CBD stones were observed in 14 patients (4.7%) and mortality in 1 high-risk patient (0.3%). Recurrent ductal stones occurred in 5 cases (1.6%) with dilated bile ducts, all after laparoscopic choledochotomy. Single-stage laparoscopic treatment of gallstones and CBD stones treats 2 problems during the same operation, avoids the additive complications of a second procedure (endoscopic sphincterotomy), and reduces hospital stay and costs. Laparoscopic management of ductal stones during laparoscopic cholecystectomy is the new "gold standard" for the treatment of gallstones and CBD stones. Copyright © 2000 by W.B. Saunders Company.
2000
Cholecystectomy; Common bile duct stones; Endoscopic sphincterotomy; Laparoscopic common bile duct exploration; Surgery
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Technical considerations and laparoscopic bile duct exploration. Transcystic and choledochotomy / Lezoche, Emanuele; Paganini, Alessandro M.. - In: SEMINARS IN LAPAROSCOPIC SURGERY. - ISSN 1071-5517. - 7:4(2000), pp. 262-278. [10.1053/slas.2000.19788]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1200484
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