The Clinical Outcome of Laparoscopic Common Bile Duct Exploration for the Primary Treatment of Choledocholithiasis.
- Author:
Yun Chul PARK
1
;
Jae Sung JEONG
;
Jong Gil JEONG
;
Chang Jin LEE
Author Information
1. Department of Surgery, Yeosu Chonnam Hospital, Korea. js5877@gmail.com
- Publication Type:Original Article
- Keywords:
Laparoscopic common bile duct exploration (LCBDE);
Choledocholithiasis
- MeSH:
Bile;
Cholangiopancreatography, Endoscopic Retrograde;
Choledocholithiasis;
Common Bile Duct;
Drainage;
Humans;
Operative Time;
Postoperative Complications;
Retrospective Studies;
Surgical Instruments
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2011;15(1):13-18
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: For choledocholithiasis, many doctors routinely use ERCP/EST to avoid the need for common bile duct exploration. But, ERCP/EST has some weakpoints. So it may not be a first choice for management, especially in secondary hospitals. Therefore, we investigated and reviewed results of LCBDE as a first treatment for common bile duct stones. METHODS: This study was a retrospective analysis of 60 cases that could be reviewed by their medical charts and who underwent LCBDE performed by the same surgeon at the Yeosu Chonnam Hospital between March, 1996 and August, 2009. The clinical data were compared between each two groups (1996~1999 vs 2000~2009 years, primary closure vs T tube drainage). RESULTS: Between groups A and B, there were no significant differences in preoperative status of the patient except for age (60.5 vs 72.6). The average operative time was decreased in group B (171.6 mins vs 143.0 mins) and the number of trocars was decreased in group B (4 vs 3.2). There were 13 postoperative complications. Among them, 11 were cases of bile leakage. All of the bile leakage cases were in group B. And there were more bile leakages in the primary repair group than in T tube drainage group (50% vs 8.9%). But, 10 cases of bile leakage were improved completely by observation and conservative treatment. CONCLUSION: LCBDE is a safe and useful treatment that has several advantages and can overcome problems not solved by ERCP. Fatal complications were not increased in the primary repair group compared with the T tube drainage group.
