Thirteen years' experience with laparoscopic transcystic common bile duct exploration for stones. Effectiveness and long-term results.
BACKGROUND
The aim of the present study was to evaluate the effectiveness and long-term results of laparoscopic transcystic common bile duct exploration (TC-CBDE).


METHODS
Ductal stones were present in 344 of 3212 patients (10.7%) who underwent laparoscopic cholecystectomy (LC). The procedure was completed laparoscopically in 329 patients (95.6%), with TC-CBDE performed in 191 patients (58.1%) who are the object of this study, or with a transverse choledochotomy in 138 cases (41.9%).


RESULTS
Biliary drainage was employed in 71 of 191 cases (37.2%). Major complications occurred in 10 patients (5.1%), including retained stones in 6 (3.1%). Mortality was nil. No patients were lost to follow-up (median: 118.0 months; range: 17.6-168 months). No signs of bile stasis, no recurrent ductal stones and no biliary stricture were observed. At present 182 patients are alive with no biliary symptoms; 9 have died from unrelated causes.


CONCLUSIONS
Long-term follow-up after laparoscopic TC-CBDE proved its effectiveness and safety for single-stage management of gallstones and common bile duct stones.
Paganini
A M
AM
Clinica di Chirurgia Generale e Metodologia Chirurgica, Università Politecnica delle Marche, Azienda Ospedaliera Umberto I, Via Conca, 60020, Ancona, Italy.
Guerrieri
M
M
Sarnari
J
J
De Sanctis
A
A
D'Ambrosio
G
G
Lezoche
G
G
Perretta
S
S
Lezoche
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D017081:Cholecystectomy, Laparoscopic; D042883:Choledocholithiasis / Q000601:surgery*; D003549:Cystic Duct; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome