[Laparoscopic treatment of common bile duct lithiasis associated with gallbladder lithiasis].
BACKGROUND
Laparoscopic bile duct exploration has become one of the main options for the treatment of choledocholithiasis associated with cholelithiasis. Our objective is to describe the results of a consecutive series of patients.


METHODS
We retrospectively analyzed 101 (66 female/16 male) patients who underwent laparoscopic bile duct exploration. Age was 58 +/- 18 years. We analyzed operaion time, hospital stay and postoperative complications according to the surgical approach (transcystic or choledochotomy). Clinical follow up was carried out for 90 days after surgery and then subsequently by telephone.


RESULTS
1435 laparoscopic cholecystectomies were performed between January 1998 and December 2005. Of those, 101 of those patients underwent laparoscopic bile duct exploration for cholelithiasis and common bile duct stones. We evaluated clinical, laboratory and ultrasound predictors: 70 patients had positive and 31 negative predictors. Laparoscopic transcystic approach was successful in 78 patients and laparoscopic choledochotomy in 17 patients. Operation time was 154 +/- 59 minutes and hospital stay 4.31 +/- 3.44 days. Six patients (5.9%) were converted to open surgery. Two patients were re-operated for postoperative bile leakage. The overall effectiveness was 94%. Postoperative mortality was 0.99%. Median follow up was 51 months. Three patients died of unrelated conditions, three underwent ERCP and one had transfistular extraction for retained stones (3.96%).


CONCLUSIONS
Laparoscopic treatment for common bile duct stones associated with gallbladder stones is a highly effective procedure with a low incidence of retained stones.
Mandry
Alexandra Catalina
AC
Sección de Hígado, Vías Biliares y Páncreas, Servicio de Cirugía General. Hospital Alemán, Buenos Aires, Argentina. alexmandry@hotmail.com
Bun
Maximiliano
M
Ued
María Laura
ML
Iovaldi
Mario Luis
ML
Capitanich
Pablo
P
D000328:Adult; D000368:Aged; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D042883:Choledocholithiasis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002769:Cholelithiasis / Q000150:complications* / Q000601:surgery; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors