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Laparoscopic management of common bile duct stones

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Abstract

Background

While laparoscopic cholecystectomy is widely accepted for therapy of cholecystolithiasis, controversy still exists concerning the management of common bile duct stones. Besides preoperative endoscopic papillotomy followed by laparoscopic cholecystectomy and open common bile duct surgery, management of common bile duct stones can be conducted by laparoscopy, if respective experience is available.

Method

During laparoscopic cholecystectomy a cholangiography via the cystic duct is routinely performed. If bile duct stones are detected they are retrieved via the cystic duct or via incision of the common bile duct by insertion of a Fogarty catheter or Dormia basket. Exclusion criteria against simultaneous laparoscopic management include suspicion of malignancy, severe pancreatitis, or cholangitis.

Results

From November 1991 to March 2002, 200 patients primarily underwent laparoscopic therapy of bile duct stones. Retrieval was performed via cystic duct and common bile duct incision in 115 and 85 cases, respectively. Complete removal was achieved in 91%; complication rate and mortality was 7% and 0.5%, respectively. During the same period primary endoscopic papillotomy was necessary in 40 patients because of the above contraindications.

Conclusions

When correct indications and surgical expertise are observed, simultaneous laparoscopic management of common bile duct stones represents a safe and minimally invasive alternative to a two-procedure approach.

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References

  1. JC Berthou F Drouard P Charbonneau K Moussalier (1998) ArticleTitleEvaluation of laparoscopic management of common bile duct stones in 220 patients. Surg Endosc 12 16–22 Occurrence Handle10.1007/s004649900585 Occurrence Handle1:STN:280:DyaK1c%2Fos1yhsg%3D%3D Occurrence Handle9419297

    Article  CAS  PubMed  Google Scholar 

  2. O Boeckl P Sungler PM Heinerman G Lexer (1994) ArticleTitleCholedocholithiasis—therapeutical splitting. Chirurgie 65 424–429 Occurrence Handle1:STN:280:ByuA38nlslU%3D

    CAS  Google Scholar 

  3. E Capelluto C Barrat JM Catheline G Champault (1999) ArticleTitleSystematic peroperative cholangiography during laparoscopic cholecystectomy. Chirurgie 124 536–541 Occurrence Handle1:STN:280:DC%2BD3c%2Fot1Kntg%3D%3D Occurrence Handle10615782

    CAS  PubMed  Google Scholar 

  4. R Coppola ME Riccioni S Ciletti L Cosentino C Coco P Magistrelli A Picciocchi (1997) ArticleTitleAnalysis of complications of endoscopic sphincterotomy for biliary stones in a consecutive series of 546 patients. Surg Endosc 11 129–132 Occurrence Handle10.1007/s004649900314 Occurrence Handle1:STN:280:ByiB383ltVQ%3D Occurrence Handle9069143

    Article  CAS  PubMed  Google Scholar 

  5. G Costamagna A Tringali SK Shak M Mutignani G Zuccala V Perri (2002) ArticleTitleLong-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence. Endoscopy 34 273–279 Occurrence Handle10.1055/s-2002-23632 Occurrence Handle1:STN:280:DC%2BD387pvFegsQ%3D%3D Occurrence Handle11932781

    Article  CAS  PubMed  Google Scholar 

  6. A Cuschieri E Lezoche M Morino E Croce A Lacy J Toouli A Faggioni VM Ribeiro J Jakimowicz J Visa GB Hanna (1999) ArticleTitleE.A.E.S. multicenter prospective randomized trial comparing two-stage vs single-stage management of patients with gallstone disease and ductal calculi. Surg Endosc 13 952–957 Occurrence Handle10.1007/s004649901145 Occurrence Handle10526025

    Article  PubMed  Google Scholar 

  7. JP Dorman Jr Franklin ME JL Glass (1998) ArticleTitleLaparoscopic common bile duct exploration by choledochotomy. An effective and efficient method of treatment of choledocholithiasis. Surg Endosc 12 926–928 Occurrence Handle10.1007/s004649900748 Occurrence Handle1:STN:280:DyaK1c3pvVeisw%3D%3D

    Article  CAS  Google Scholar 

  8. InstitutionalAuthorNameE.A.E.S. (1998) ArticleTitleDiagnosis and treatment of common bile duct stones (CBDS). Results of a consensus development conference. Scientific Committee of the European Association for Endoscopic Surgery (E.A.E.S.). Surg Endosc 12 856–864 Occurrence Handle10.1007/s004649900729 Occurrence Handle9602006

    Article  PubMed  Google Scholar 

  9. LE Hammarstrom H Stridbeck I Ihse (1996) ArticleTitleLong-term follow-up after endoscopic treatment of bile duct calculi in cholecystectomized patients. World J Surg 20 272–276 Occurrence Handle10.1007/s002689900043 Occurrence Handle1:STN:280:BymA38rmt1c%3D Occurrence Handle8661830

    Article  CAS  PubMed  Google Scholar 

  10. MJ Heili NK Wintz DL Fowler (1999) ArticleTitleCholedocholithiasis: endoscopic versus laparoscopic management. Am Surg 65 135–138 Occurrence Handle1:STN:280:DyaK1M7itl2gtQ%3D%3D Occurrence Handle9926747

    CAS  PubMed  Google Scholar 

  11. PM Heinerman O Boeckl W Pimpl (1989) ArticleTitleSelective ERCP and preoperative stone removal in bile duct surgery. Ann Surg 209 267–272 Occurrence Handle1:STN:280:BiaC28rltFw%3D Occurrence Handle2923513

    CAS  PubMed  Google Scholar 

  12. TP Huttl CH Hrdina TK Geiger G Meyer FW Schildberg HJ Kramling (2002) ArticleTitleManagement of common bile duct stones. Results of a nationwide survey with analysis of 8433 common bile duct explorations in Germany. Zentralbl Chir 127 282–288 Occurrence Handle10.1055/s-2002-31562-1 Occurrence Handle12085276

    Article  PubMed  Google Scholar 

  13. HJ Kramling V Lange G Heberer (1993) ArticleTitleCurrent status of gallstone surgery in Germany. Results of a survey and retrospective analysis of 27,403 interventions—open vs. laparoscopic surgery. Chirurgie 64 295–302 Occurrence Handle1:STN:280:ByyB2crlslQ%3D

    CAS  Google Scholar 

  14. E Lezoche AM Paganini (2000) ArticleTitleTechnical considerations and laparoscopic bile duct exploration: transcystic and choledochotomy. Semin Laparosc Surg 7 262–278 Occurrence Handle10.1053/slas.2000.19788 Occurrence Handle1:STN:280:DC%2BD3MzjslSksQ%3D%3D Occurrence Handle11323763

    Article  CAS  PubMed  Google Scholar 

  15. K Ludwig F Koeckerling W Hohenberger D Lorenz (2001) ArticleTitleSurgical therapy in cholecysto-/choledocholithiasis. Results of a Germany-wide questionnaire sent to 859 clinics with 123,090 cases of cholecystectomy. Chirurgie 72 1171–1178 Occurrence Handle10.1007/s001040170056 Occurrence Handle1:STN:280:DC%2BD3MnmvFyhtQ%3D%3D

    Article  CAS  Google Scholar 

  16. K Ludwig J Bernhardt H Steffen D Lorenz (2002) ArticleTitleContribution of intraoperative cholangiography to incidence and outcome of common bile duct injuries during laparoscopic cholecystectomy. Surg Endosc 16 1098–1104 Occurrence Handle10.1007/s00464-001-9183-6 Occurrence Handle1:STN:280:DC%2BD38vhtFGjsQ%3D%3D Occurrence Handle12165830

    Article  CAS  PubMed  Google Scholar 

  17. B Millat J Atger A Deleuze H Briandet A Fingerhut F Guillon E Marrel C Seguin ParticleDe P Soulier (1997) ArticleTitleLaparoscopic treatment for choledocholithiasis: a prospective evaluation in 247 consecutive unselected patients. Hepatogastroenterology 44 28–34 Occurrence Handle1:STN:280:ByiB3M7htFI%3D Occurrence Handle9058114

    CAS  PubMed  Google Scholar 

  18. JP Neoptolemos DL Carr-Locke DP Fossard (1987) ArticleTitleProspective randomised study of preoperative endoscopic sphinkterotomy versus surgery alone for common bile duct stones. Br Med J 234 470–477

    Google Scholar 

  19. AM Paganini F Feliciotti M Guerrieri A Tamburini R Campagnacci E Lezoche (2002) ArticleTitleLaparoscopic cholecystectomy and common bile duct exploration are safe for older patients. Surg Endosc 16 1302–1308 Occurrence Handle10.1007/s00464-001-8316-2 Occurrence Handle1:STN:280:DC%2BD38vntlGqsA%3D%3D Occurrence Handle12000984

    Article  CAS  PubMed  Google Scholar 

  20. JC Pereira-Lima R Jakobs UH Winter C Benz WR Martin HE Adamek JF Riemann (1998) ArticleTitleLong-term results (7 to 10 years) of endoscopic papillotomy for choledocholithiasis. Multivariate analysis of prognostic factors for the recurrence of biliary symptoms. Gastrointest Endosc 48 457–464 Occurrence Handle1:STN:280:DyaK1M%2FkvVKksA%3D%3D Occurrence Handle9831832

    CAS  PubMed  Google Scholar 

  21. JC Pereira-Lima CB Rynkowski EL Rhoden (2001) ArticleTitleEndoscopic treatment of choledocholithiasis in the era of laparoscopic cholecystectomy: prospective analysis of 386 patients. Hepatogastroenterology 48 1271–1274 Occurrence Handle1:STN:280:DC%2BD3MrntFajtQ%3D%3D Occurrence Handle11677944

    CAS  PubMed  Google Scholar 

  22. HA Pitt (1993) ArticleTitleRole of open choledochotomy in the treatment of choledocholithiasis. Am J Surg 165 483–486 Occurrence Handle8480887

    PubMed  Google Scholar 

  23. J Rechner S Beller A Zerz G Szinicz (1996) ArticleTitleDouble balloon catheter for facilitating (laparoscopic) choledochus drainage. Chirurg 67 1266–1269 Occurrence Handle10.1007/s001040050137 Occurrence Handle1:STN:280:ByiC28vnvVc%3D Occurrence Handle9081791

    Article  CAS  PubMed  Google Scholar 

  24. M Rhodes L Sussmann L Cohen MP Lewis (1998) ArticleTitleRandomised trial of laparoscopic exploration of common bile duct versus postoperative endoscopic retrograde cholangiography for common bile duct stones. Lancet 351 159–161 Occurrence Handle1:STN:280:DyaK1c7htFGhsA%3D%3D Occurrence Handle9449869

    CAS  PubMed  Google Scholar 

  25. R Riciardi S Islam JJ Canete PL Arcand ME Stoker (2003) ArticleTitleEffectiveness and long-term results of laparoscopic common bile duct exploration. Surg Endosc 17 19–22 Occurrence Handle10.1007/s00464-002-8925-4 Occurrence Handle1:STN:280:DC%2BD3s%2FmtFKhtg%3D%3D Occurrence Handle12399840

    Article  CAS  PubMed  Google Scholar 

  26. SAGES (1994) ArticleTitleGuidelines for the clinical application of laparoscopic biliary tract surgery. Surg Endosc 8 1457–1458 Occurrence Handle7878519

    PubMed  Google Scholar 

  27. Jr Sivak MV (1989) ArticleTitleEndoscopic management of bile duct stones. Am J Surg 158 228–240 Occurrence Handle2672845

    PubMed  Google Scholar 

  28. N Soehendra H Seifert F Thonke U Seitz YG Wang (1994) ArticleTitleEndoscopic techniques in therapy of choledocholithiasis. Chirurgie 65 413–417 Occurrence Handle1:STN:280:ByuA38nls10%3D

    CAS  Google Scholar 

  29. H Tokumura A Umezawa H Cao N Sakamoto Y Imaoka A Ouchi K Yamamoto (2002) ArticleTitleLaparoscopic management of common bile duct stones: transcystic approach and choledochotomy. J Hepatobil Pancreat Surg 9 206–212 Occurrence Handle10.1007/s005340200020

    Article  Google Scholar 

  30. SE Tranter MH Thompson (2002) ArticleTitleComparison of endoscopic sphincterotomy and laparoscopic exploration of the common bile duct. Br J Surg 89 1495–1504 Occurrence Handle10.1046/j.1365-2168.2002.02291.x Occurrence Handle1:STN:280:DC%2BD38noslWquw%3D%3D Occurrence Handle12445057

    Article  CAS  PubMed  Google Scholar 

  31. VL Wills K Gibson C Karihaloot JO Jorgensen (2002) ArticleTitleComplications of biliary T-tubes after choledochotomy. ANZ J Surg 72 177–180 Occurrence Handle10.1046/j.1445-2197.2002.02308.x Occurrence Handle12071447

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgery, General Hospital Bregenz, C.-Pedenz-Str. 2, 6900 Bregenz, Austria

    S. Ebner, J. Rechner, S. Beller & G. Szinicz

  2. Department of Internal Medicine, General Hospital Bregenz, C.-Pedenz-Str. 2, 6900 Bregenz, Austria

    K. Erhart

  3. Department of General Surgery, University Clinic of Surgery, Vienna, Vienna Medical School, Waehringer Guertel 18-20, 1090 Vienna, Austria

    F. M. Riegler

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  1. S. Ebner
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  2. J. Rechner
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  3. S. Beller
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  6. G. Szinicz
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Corresponding author

Correspondence to S. Ebner.

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Ebner, S., Rechner, J., Beller, S. et al. Laparoscopic management of common bile duct stones. Surg Endosc 18, 762–765 (2004). https://doi.org/10.1007/s00464-003-9029-5

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  • DOI: https://doi.org/10.1007/s00464-003-9029-5

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