title: Laparoscopic common bile duct exploration and primary closure of choledochotomy after failed endoscopic sphincterotomy.
abstract: BACKGROUND
  The aim of this study is to evaluate the safety and feasibility of laparoscopic common bile duct exploration and primary closure of choledochotomy for the patients with common bile duct stones (CBDS) who failed in endoscopic sphincterotomy (EST).
  
  
  METHODS
  Between January 2007 and June 2012, a total of 78 patients who subjected to endoscopic retrograde cholangiopancreatography (ERCP) and EST, but failed in endoscopic stone extraction, were referred to us. The following day, laparoscopic cholecystectomy, laparoscopic common bile duct exploration (LCBDE) and primary closure of choledochotomy were performed in all patients.
  
  
  RESULTS
  No intraoperative complications were experienced in the patients. 6 patients required conversion to open cholecystectomy due to impacted stones. The mean operative time was 145 min. The mean postoperative hospital stay was 6d. All the patients achieved successful stone clearance. 13 cases had slight bile leaks, which resolved spontaneously. None of the patients experienced biliary peritonitis, biliary fistula, pancreatitis, or cholangitis.
  
  
  CONCLUSIONS
  If it is performed by experienced laparoscopic surgeons, primary closure following immediate laparoscopic common bile duct exploration (LCBDE) is safe and feasible for patients with CBDS who fail in endoscopic stone extraction.
authors.affiliation: Department of General Surgery, Yancheng City No. 1 People's Hospital, Yancheng 224005, China. Electronic address: zhouyong13616@sina.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Gastroenterology, Yancheng City No. 1 People's Hospital, 16 Yuehe Road, Yancheng 224005, Jiangsu Province, China. Electronic address: hnjsycwxd@163.com.
authors.forename: Xu-Dong
authors.initials: XD
authors.lastname: Wu
authors.affiliation: Department of General Surgery, Yancheng City No. 1 People's Hospital, Yancheng 224005, China.
authors.forename: Ren-Gen
authors.initials: RG
authors.lastname: Fan
authors.affiliation: Department of General Surgery, Yancheng City No. 1 People's Hospital, Yancheng 224005, China.
authors.forename: Guang-Jun
authors.initials: GJ
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, Yancheng City No. 1 People's Hospital, Yancheng 224005, China.
authors.forename: Xiang-Ming
authors.initials: XM
authors.lastname: Mu
authors.affiliation: Department of General Surgery, Yancheng City No. 1 People's Hospital, Yancheng 224005, China.
authors.forename: Wen-Zhang
authors.initials: WZ
authors.lastname: Zha
authors.affiliation: Department of Nephrology, Yancheng City No. 1 People's Hospital, Yancheng 224005, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Jia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D005240:Feasibility Studies; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome
keywords: Common bile duct stones; ERCP/EST; Laparoscopic common bile duct exploration; Primary closure