Choledocholithiasis
Conditions
Keywords
choledochotomy technique, CBD stones, choledocholithiasis
Brief summary
complications after laparoscopic common bile duct exploration (LCBDE) regarding the choledochotomy technique have not been adequately studied in the literature. Therefore, this study aimed to retrospectively analyze and compare the impact of choledochotomy techniques during LCBDE among patients with choledocholithiasis during the early and late postoperative periods.
Detailed description
Background: complications after laparoscopic common bile duct exploration (LCBDE) regarding the choledochotomy technique have not been adequately studied in the literature. Therefore, this study aimed to retrospectively analyze and compare the impact of choledochotomy techniques during LCBDE among patients with choledocholithiasis during the early and late postoperative periods. Methods: from March 2014 to February 2018, 85 patients with choledocholithiasis (52 females and 33 males) were enrolled in this study. These patients were treated by LCBDE using various choledochotomy techniques, including scalpel or scissor (28 patients, 33%) in group I, using diathermy hook (35 patients, 41%) in group II, or using an ultrasonic device (22 patients, 26 %) in group III. Postoperative follow-up was done for assessment of all possible complications either early (within 3-6 months postoperatively), or late (2-6 years postoperatively) with meticulous observation and study of any relevant postoperative event.
Interventions
PROCEDUREcholedochotomy techniques during LCBDE
Sponsors
Sohag University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
17 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All adult patients with choledocholithiasis who underwent LCBDE combined with LC were enrolled in this study. No limitations as regards the stone sizes or numbers were considered. The CBD diameter should be at least ± 1 cm.
Exclusion criteria
*
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| biliary leakage/fistula | first postoperative 6 months up to 6 years postoperatively | According to the international study group of liver surgery, bile leakage is defined as fluid with an elevated bilirubin level (3 times higher than the serum bilirubin measured at the same time) in the abdominal drain or the intra-abdominal fluid on or after POD 3, or as the need for radiologic intervention because of biliary collections or re-laparotomy resulting from biliary peritonitis |
| biliary stricture | 2-6 years | The biliary stricture is known as abnormal narrowing of the bile duct associated with the rising of cholestasis indexes. Additionally, it has required an invasive treatment such as ERCP, percutaneous transhepatic drainage, or re-surgery \[16\]. Biliary complications were diagnosed by trans-tubal cholangiography or through MRCP and could be managed conservatively, ERCP, if there is an accessible route, PTD or surgical intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| conversion rate | during surgery | from laparoscopy to open |
| jaundice | 2-6 years | missed stone |
| wound sepsis | 2-6 years | infection of the wound |
| operative time | from incision to closure | from incision to closure |
| wound dehiscence | 2-6 years | Gapped wound |
| Peritoneal sepsis and abscess | first postoperative 6 months | peritonitis |
| Recurrent stones | 2-6 years | recurrence |
| cholangitis | 2-6 years | inflammation of the biliary system |
| intraoperative bleeding | during surgery | in mm |
Countries
Egypt
Outcome results
None listed