title: Early versus delayed laparoscopic common bile duct exploration for common bile duct stone-related nonsevere acute cholangitis.
abstract: It is undetermined when and how laparoscopic common bile duct exploration (LCBDE) should be used in patients with common bile duct (CBD) stone-related nonsevere acute cholangitis. We aimed to evaluate the effect of LCBDE on the clinical outcome of those patients within (early) or beyond (delayed) 72 hours of emergent admission. Surgery-related complications, length of hospital stay (LOS), and total cost, as well as demographic and clinical parameters were compared between the two groups. Finally, 3 and 5 patients in early and delayed LCBDE group, respectively, had retained stones, which were removed by choledochoscopy before T-tube was removed. Each group had 3 patients who developed biliary leak, which was conservatively cured by the drainage. Shorter LOS and less total cost were observed in early group compared to the late one (13.34 ± 4.48 vs. 18.32 ± 9.13, p < 0.05; 17712 ± 5446.63 vs. 21776 ± 7230.41 ¥RMB, p < 0.05). Improvement of cholangitis was achieved in all patients with LCBDE. None of the patients developed stricture of the CBD after LCBDE. To conclude, both early and delayed LCBDE are safe and effective for the treatment of CBD stone-related nonsevere acute cholangitis during emergent admissions. Early LCBDE may be superior to delayed procedure due to the shorter LOS and less cost.
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Dan
authors.initials: D
authors.lastname: Li
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Buhe
authors.initials: B
authors.lastname: Amin
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Ke
authors.initials: K
authors.lastname: Gong
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Louisville School of Medicine, Louisville, Kentucky, US.
authors.forename: Ming
authors.initials: M
authors.lastname: Song
authors.affiliation: Laparoscopic Surgical Center, Department of General Surgery of Beijing Shijitan Hospital, Capital Medical University. Tieyilu 10, Yangfangdian, Haidian District, Beijing 100038, P.R. China.
authors.forename: Nengwei
authors.initials: N
authors.lastname: Zhang
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002761:Cholangitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D003135:Common Bile Duct / Q000473:pathology*; D005260:Female; D042882:Gallstones / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome