Single-stage laparoscopic treatment of gallstones and common bile duct stones in 120 unselected, consecutive patients.
Feasibility, success rate, safety, and short-term results of single-stage, laparoscopic, transcystic--whenever possible--or choledochotomic treatment of gallstones and common bile duct (CBD) stones were evaluated in 120 unselected patients. Of 1095 patients who underwent laparoscopic cholecystectomy, 120 had ductal stones; among those patients, stones were suspected or proven in 72, 27 of whom were referred after failed endoscopic sphincterotomy (ES) performed elsewhere; unsuspected CBD stones were discovered in 48. The procedure was successful in 116 patients. Four patients required conversion to open surgery. The transcystic access was feasible in 77 patients; a choledochotomy was required in 39. Incidence of retained CBD stones was 4.3%. Minor complications, major complications, and mortality were observed in 6.8%, 1.7%, and 0.8% of patients, respectively. Single-stage laparoscopic treatment of gallstones and CBD stones in unselected patients is safe and feasible in the majority of cases, with success rates and short-term results that are not inferior to reported results of ERCP/ES and cholecystectomy.
Lezoche
E
E
Cattedra di Chirurgia Generale I, Università di Ancona, Italy.
Paganini
A M
AM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome