title: Laparoscopic management after failed endoscopic stone removal in nondilated common bile duct.
abstract: BACKGROUND
  When common bile duct (CBD) stone removal by endoscopic procedure fails, CBD exploration is an alternative procedure. However, nondilated CBD is a contraindication to choledochotomy. The purpose of this study was to investigate the results of laparoscopic CBD exploration (LCBDE) following unsuccessful endoscopic stone removal in nondilated CBD.
  
  
  METHODS
  From January 2011 to June 2015, we retrospectively analyzed 165 LCBDEs. Group 1 was defined as patients with nondilated CBD who underwent LCBDE after failed endoscopic stone removal. Group 2 included patients with dilated CBD who received LCBDE. Outcomes of LCBDE were compared between the two groups.
  
  
  RESULTS
  There were 23 patients in Group 1 and 142 in Group 2. No significant differences were observed in demographics other than CBD diameter. There was no significant difference in operating time, postoperative hospital stay, open conversion rate, overall postoperative complication rate, retained stone rate, and recurrence rate between the two groups.
  
  
  CONCLUSIONS
  LCBDE in experienced hands is a safe and feasible option after failure of endoscopic stone removal in nondilated CBD. However, larger numbers of cases and longer follow-up are required to validate LCBDE in nondilated CBD.
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou People's Hospital, The Fifth Affiliated Hospital of Medical School of Nantong University, Taizhou 225300, Jiangsu Province, China. Electronic address: xkfy1979@126.com.
authors.forename: Zang
authors.initials: Z
authors.lastname: Jinfeng
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou People's Hospital, The Fifth Affiliated Hospital of Medical School of Nantong University, Taizhou 225300, Jiangsu Province, China. Electronic address: 61736144@qq.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yin
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou People's Hospital, The Fifth Affiliated Hospital of Medical School of Nantong University, Taizhou 225300, Jiangsu Province, China. Electronic address: zhcsir2000@sina.com.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Chi
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou People's Hospital, The Fifth Affiliated Hospital of Medical School of Nantong University, Taizhou 225300, Jiangsu Province, China. Electronic address: gjy1215@tom.com.
authors.forename: Gao
authors.initials: G
authors.lastname: Junye
mesh_terms: D000328:Adult; D000368:Aged; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D042883:Choledocholithiasis / Q000601:surgery*; D003135:Common Bile Duct / Q000473:pathology / Q000601:surgery*; D004108:Dilatation, Pathologic / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D017211:Treatment Failure
keywords: Choledocholithiasis; Endoscopic surgery; Laparoscopic surgery