Approaches and indications in laparoscopic choledoscopy
Objectives. Up to 20% of patients with biliary lithiasis have bile duct stones, which are asymptomatic in 50% of cases. The aim of the study was to evaluate the role of choledoscopy in extracting stones from the main bile ducts. Materials and Methods. This is a retrospective study (January 2014 - De...
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MDPI AG
2024-10-01
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| Series: | Journal of Mind and Medical Sciences |
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| Online Access: | https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1563&context=jmms |
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| author | Iulian Slavu Raluca Tulin Ileana Dima Alexandru Dogaru Florin Filipou Bogdan Socea Anca Monica Oprescu-Macovei Adrian Tulin |
| author_facet | Iulian Slavu Raluca Tulin Ileana Dima Alexandru Dogaru Florin Filipou Bogdan Socea Anca Monica Oprescu-Macovei Adrian Tulin |
| author_sort | Iulian Slavu |
| collection | DOAJ |
| description | Objectives. Up to 20% of patients with biliary lithiasis have bile duct stones, which are asymptomatic in 50% of cases. The aim of the study was to evaluate the role of choledoscopy in extracting stones from the main bile ducts. Materials and Methods. This is a retrospective study (January 2014 - December 2024) on 2309 patients who underwent a laparoscopic cholecystectomy. Laparoscopic choledoscopy was performed in 32 cases. Of the 32 patients with complete clearance, none had residual common bile duct stones (CBDS) at 1 year postoperatively. Results. The ideal approach in our study was the transcystic approach, with the shortest hospital stays (mean 3 days) transcholedochal approach; it was only feasible in 7 patients. All patients had transcystic drainage that was removed after 10 days (mean operative time 105 min). The transcholedochal approach was demanding from a technical point of view. Primary ductal closure was performed in 5 patients. Ductal closure with transcystic drain was in 9 patients. A total of 14 patients had a T-tube and a longer operative time (on average 170 min). Conversion to open surgery was performed in 4 cases, due to difficult dissection at the level of the hepatic porta. Conclusions. LCBDE for previously documented or discovered CBDS during LC is a safe and feasible procedure. The technique is technically demanding, and requires advanced laparoscopic skills. Patient selection is very important, but the transcystic approach for LCBDE when possible is optimal. |
| format | Article |
| id | doaj-art-7890cca10d5d4ad7aa9b7c0f2fe3b31e |
| institution | Kabale University |
| issn | 2392-7674 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Mind and Medical Sciences |
| spelling | doaj-art-7890cca10d5d4ad7aa9b7c0f2fe3b31e2025-08-20T03:35:11ZengMDPI AGJournal of Mind and Medical Sciences2392-76742024-10-0111248248710.22543/2392-7674.1563Approaches and indications in laparoscopic choledoscopyIulian Slavu0Raluca Tulin1Ileana Dima2Alexandru Dogaru3Florin Filipou4Bogdan Socea5Anca Monica Oprescu-Macovei6Adrian Tulin7Carol Davila University of Medicine and Pharmacy, Department of Anatomy, Bucharest, RomaniaAgrippa Ionescu Emergency Clinical Hospital, Department of Endocrinology, Bucharest, RomaniaAgrippa Ionescu Emergency Clinical Hospital, Department of General Surgery, Bucharest, RomaniaAgrippa Ionescu Emergency Clinical Hospital, Department of General Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Department of Anatomy, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Department of Surgery, Bucharest, RomaniaAgrippa Ionescu Emergency Clinical Hospital, Department of Gastroenterology, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Department of Anatomy, Bucharest, RomaniaObjectives. Up to 20% of patients with biliary lithiasis have bile duct stones, which are asymptomatic in 50% of cases. The aim of the study was to evaluate the role of choledoscopy in extracting stones from the main bile ducts. Materials and Methods. This is a retrospective study (January 2014 - December 2024) on 2309 patients who underwent a laparoscopic cholecystectomy. Laparoscopic choledoscopy was performed in 32 cases. Of the 32 patients with complete clearance, none had residual common bile duct stones (CBDS) at 1 year postoperatively. Results. The ideal approach in our study was the transcystic approach, with the shortest hospital stays (mean 3 days) transcholedochal approach; it was only feasible in 7 patients. All patients had transcystic drainage that was removed after 10 days (mean operative time 105 min). The transcholedochal approach was demanding from a technical point of view. Primary ductal closure was performed in 5 patients. Ductal closure with transcystic drain was in 9 patients. A total of 14 patients had a T-tube and a longer operative time (on average 170 min). Conversion to open surgery was performed in 4 cases, due to difficult dissection at the level of the hepatic porta. Conclusions. LCBDE for previously documented or discovered CBDS during LC is a safe and feasible procedure. The technique is technically demanding, and requires advanced laparoscopic skills. Patient selection is very important, but the transcystic approach for LCBDE when possible is optimal. https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1563&context=jmmscholedoscopylaparoscopysurgeryapproachesindications |
| spellingShingle | Iulian Slavu Raluca Tulin Ileana Dima Alexandru Dogaru Florin Filipou Bogdan Socea Anca Monica Oprescu-Macovei Adrian Tulin Approaches and indications in laparoscopic choledoscopy Journal of Mind and Medical Sciences choledoscopy laparoscopy surgery approaches indications |
| title | Approaches and indications in laparoscopic choledoscopy |
| title_full | Approaches and indications in laparoscopic choledoscopy |
| title_fullStr | Approaches and indications in laparoscopic choledoscopy |
| title_full_unstemmed | Approaches and indications in laparoscopic choledoscopy |
| title_short | Approaches and indications in laparoscopic choledoscopy |
| title_sort | approaches and indications in laparoscopic choledoscopy |
| topic | choledoscopy laparoscopy surgery approaches indications |
| url | https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1563&context=jmms |
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