Abstract
Purpose
Previous gastrectomy (PG) can lead to an increased incidence of biliary stones. However, the success rate of endoscopic retrograde cholangiopancreatography after gastrectomy remains low. In such cases, laparoscopic common bile duct exploration (LCBDE) may be an alternative. The aim of this study was to evaluate the safety and feasibility of LCBDE for patients who underwent PG.
Methods
A retrospective analysis of patients with a history of LCBDE was conducted. Patients were divided into two groups according to their PG status, and their perioperative data were compared.
Results
The outcomes of 27 patients with a history of gastrectomy were compared with those of 155 without a history of gastrectomy who underwent LCBDE. PG patients experienced longer hospitalization times (P = 0.006), more postoperative bleeding (p = 0.021), a lower incidence of preoperative endoscopic retrograde cholangiopancreatography (P < 0.001), and a higher incidence of T-tube application (p = 0.002) than those without gastrectomy. However, there were no significant differences in estimated blood loss volume, operation time, bile leakage status, pancreatitis status, stone clearance rate, readmission rate, or recurrence rate.
Conclusions
Although LCBDE following gastrectomy may require laborious perioperative management, a history of gastrectomy might not influence the feasibility or safety of LCBDE, as its perioperative outcomes are comparable to those in patients without a history of gastrectomy.
Similar content being viewed by others
Data availability
The data is available regarding this paper.
References
Osnes M, Rosseland A, Aabakken L (1986) Endoscopic retrograde cholangiography and endoscopic papillotomy in patients with a previous Billroth-II resection. Gut 27(10):1193–1198
Costamagna G, Mutignani M, Perri V, Gabrielli A, Locicero P, Crucitti F (1994) Diagnostic and therapeutic ERCP in patients with Billroth II gastrectomy. Acta Gastro-Enterol Belg 57(2):155–162
Bove V, Tringali A, Familiari P, Gigante G, Boškoski I, Perri V, Mutignani M, Costamagna G (2015) ERCP in patients with prior Billroth II gastrectomy: report of 30 years’ experience. Endoscopy 47(07):611–616
Park TY, Song TJ (2019) Recent advances in endoscopic retrograde cholangiopancreatography in Billroth II gastrectomy patients: a systematic review. World J Gastroenterol 25(24):3091
Zhang M, Zhang J, Sun X, Xu J, Zhu J, Yuan W, Yan Q (2018) Clinical analysis of treatment strategies to cholecystocholedocholithiasis patients with previous subtotal or total gastrectomy: a retrospective cohort study. BMC Surg 18(1):1–8
Huang Y, Feng Q, Wang K, Xiong X, Zou S (2017) The safety and feasibility of laparoscopic common bile duct exploration for treatment patients with previous abdominal surgery. Sci Rep 7(1):1–6
Zhang K, Zhan F, Zhang Y, Jiang C, Zhang M, Yu X, Ma T, Wu H (2016) Primary closure following laparoscopic common bile duct reexploration for the patients who underwent prior biliary operation. Indian J Surg 78(5):364–370
Zhu J, Sun G, Hong L, Li X, Li Y, Xiao W (2018) Laparoscopic common bile duct exploration in patients with previous upper abdominal surgery. Surg Endosc 32(12):4893–4899
Li M, Tao Y, Shen S, Song L, Suo T, Liu H, Wang Y, Zhang D, Ni X, Liu H (2020) Laparoscopic common bile duct exploration in patients with previous abdominal biliary tract operations. Surg Endosc 34(4):1551–1560
Han J, Kim KY, Kim HG, Kim BS, Jung JT, Lee CH, Kwon JG, Kim EY (2010) T1542: late complications and stone recurrence rate after endoscopic removal of large bile duct stones by endoscopic sphincterotomy and large balloon dilatation are similar to those of endoscopic sphincterotomy alone. Gastrointest Endosc 71(5):304
Cai L-X, Tong Y-F, Yu H, Liang X, Liang Y-L, Cai X-J (2016) Is laparoscopic hepatectomy a safe, feasible procedure in patients with a previous upper abdominal surgery? Chin Med J 129(04):399–404
Wiebke E, Pruitt A, Howard T, Jacobson L, Broadie T, Goulet R, Canal D (1996) Conversion of laparoscopic to open cholecystectomy. Surg Endosc 10(7):742–745
Cipriani F, Ratti F, Fiorentini G, Catena M, Paganelli M, Aldrighetti L (2018) Effect of previous abdominal surgery on laparoscopic liver resection: analysis of feasibility and risk factors for conversion. J Laparoendosc Adv Surg Tech 28(7):785–791
Author information
Authors and Affiliations
Contributions
Kwang Yeol Paik: conceptualization, data curation, methodology, formal analysis, writing—review and editing. Sun Min Park: data curation, formal analysis, writing original draft.
Corresponding author
Ethics declarations
Ethical approval
This study was approved by the Ethics Committee for Clinical Research of Yeouido St. Mary’s Hospital.
Competing interests
The authors declare no competing interests.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Park, S.M., Paik, K.Y. Laparoscopic common bile duct exploration following prior gastrectomy: surgical safety and feasibility. Langenbecks Arch Surg 408, 287 (2023). https://doi.org/10.1007/s00423-023-03029-6
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s00423-023-03029-6