title: Laparoscopic common bile duct exploration in cirrhotic patients with choledocholithiasis.
abstract: OBJECTIVE
  Although laparoscopic common bile duct exploration (LCBDE) has become the standard procedure for most choledocholithiasis patients, the application of this procedure to liver cirrhosis is still in debate. The aim of the current study was to evaluate the feasibility and safety of LCBDE in choledocholithiasis patients with compensated liver cirrhosis.
  
  
  METHODS
  From January 2006 to December 2012, 346 LCBDEs were performed in our hospital. According to the previously defined liver condition, the patients were divided into group A (liver cirrhosis, n=132) and group B (without cirrhosis, n=214). The perioperative data for the 2 groups were retrospectively reviewed and compared.
  
  
  RESULTS
  LCBDE was successfully completed in 326 patients. Conversion from laparoscopic to open surgery was necessary for 20 patients (5.7%) mainly because of hemorrhage (5, 25%) and severe adhesions (8, 40%). A T-tube was placed in 211 patients (64.7%), and primary closure was performed in 115 (35.3%) patients. There was a significant difference for groups A and B in terms of intraoperative blood loss (85 vs. 35 mL; P<0.01). However, the 2 groups showed no significant differences with respect to the mean operation time (2.1 vs. 1.9 h; P=0.07), complication rates (10.6% vs. 8.8%; P=0.6), mean hospital stay (4.2 vs. 4.0 d; P=0.6), conversion rate (5.3% vs. 6.1%; P=0.77), and retained choledocholithiasis rate (8.3% vs. 7.1%; P=0.65). There was no mortality in both groups.
  
  
  CONCLUSIONS
  LCBDE is a feasible, effective, and safe surgical procedure for choledocholithiasis patients with compensated cirrhosis.
authors.affiliation: Departments of *Hepatobiliary Pancreatic Surgery †Urology Surgery, West China Hospital, Sichuan University, Cheng du, Sichuan Province, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Qiu
authors.forename: Haichao
authors.initials: H
authors.lastname: Yuan
authors.forename: Shuting
authors.initials: S
authors.lastname: Chen
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D042883:Choledocholithiasis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome