title: Results of Medium Seventeen Years' Follow-Up after Laparoscopic Choledochotomy for Ductal Stones.
abstract: Introduction. In a previously published article the authors reported the long-term follow-up results in 138 consecutive patients with gallstones and common bile duct (CBD) stones who underwent laparoscopic transverse choledochotomy (TC) with T-tube biliary drainage and laparoscopic cholecystectomy (LC). Aim of this study is to evaluate the results at up to 23 years of follow-up in the same series. Methods. One hundred twenty-one patients are the object of the present study. Patients were evaluated by clinical visit, blood assay, and abdominal ultrasound. Symptomatic patients underwent cholangio-MRI, followed by endoscopic retrograde cholangiopancreatography (ERCP) as required. Results. Out of 121 patients, 61 elderly patients died from unrelated causes. Fourteen patients were lost to follow-up. In the 46 remaining patients, ductal stone recurrence occurred in one case (2,1%) successfully managed by ERCP with endoscopic sphincterotomy. At a mean follow-up of 17.1 years no other patients showed signs of bile stasis and no patient showed any imaging evidence of CBD stricture at the site of choledochotomy. Conclusions. Laparoscopic transverse choledochotomy with routine T-tube biliary drainage during LC has proven to be safe and effective at up to 23 years of follow-up, with no evidence of CBD stricture when the procedure is performed with a correct technique.
authors.affiliation: Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini", Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Quaresima
authors.affiliation: Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini", Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Balla
authors.affiliation: Department of General Surgery, Polytechnical University of Marche, 60121 Ancona, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Guerrieri
authors.affiliation: Department of General Surgery, Polytechnical University of Marche, 60121 Ancona, Italy.
authors.forename: Giovanni
authors.identifier: 0000-0002-4210-6386
authors.initials: G
authors.lastname: Lezoche
authors.affiliation: Department of General Surgery, Polytechnical University of Marche, 60121 Ancona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Campagnacci
authors.affiliation: Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini", Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: D'Ambrosio
authors.affiliation: Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini", Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Lezoche
authors.affiliation: Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini", Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Alessandro M
authors.initials: AM
authors.lastname: Paganini