Comparing a single-staged laparoscopic cholecystectomy with common bile duct exploration versus a two-staged endoscopic sphincterotomy followed by laparoscopic cholecystectomy
| Autor: | Shili Ning, Chenggong Sun, Yanying Ren, Guoxin Guan, Zhengdong Zhao |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Anastomotic Leak 030230 surgery Anastomosis Sphincterotomy Endoscopic 03 medical and health sciences 0302 clinical medicine medicine Humans Laparoscopic cholecystectomy Aged Retrospective Studies Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Common Bile Duct Common bile duct exploration business.industry Incidence Anastomosis Surgical Retrospective cohort study Patient data Length of Stay Middle Aged Surgery Choledocholithiasis Treatment Outcome Cholecystectomy Laparoscopic Biliary sphincterotomy Endoscopic retrograde cholangiography Female 030211 gastroenterology & hepatology Cholecystectomy business |
| Zdroj: | Surgery. 164:1030-1034 |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/j.surg.2018.05.052 |
| Popis: | With the advent of minimally invasive surgery, the limits of surgery have been stretched by questioning the more usual, established 2-stage approach for choledocholithiasis with an initial endoscopic retrograde cholangiography and endoscopic biliary sphincterotomy followed by laparoscopic cholecystectomy in favor of the single-stage laparoscopic common bile duct exploration with laparoscopic cholecystectomy. The aim of this study was to compare the related benefits, difficulties, and outcomes of these 2 methods at a single institution.A retrospective analysis of 128 patients satisfying the inclusion criteria was divided into 2 groups (n = 68 for the group with laparoscopic common bile duct exploration with laparoscopic cholecystectomy and n = 60 for the group with endoscopic retrograde cholangiography/laparoscopic cholecystectomy) between 2014 and 2017. Patient data including age, sex, duration of the operation, intraoperative and postoperative complications, and duration of hospital stay were reviewed.The group with laparoscopic common bile duct exploration with laparoscopic cholecystectomy had 24 men and 44 women (mean age 52 years), and the group with endoscopic retrograde cholangiography/laparoscopic cholecystectomy had 16 men and 44 women (mean age 47 years). Statistically significant results were found in the clearance range (100% in the group with laparoscopic common bile duct exploration with laparoscopic cholecystectomy versus 75% in the group with endoscopic retrograde cholangiography/laparoscopic cholecystectomy), a shorter total duration of hospitalization for the group with laparoscopic common bile duct exploration with laparoscopic cholecystectomy (4.1 days vs 8.4 days) (P.05), but a great incidence of biliary leakage in the group with laparoscopic common bile duct exploration with laparoscopic cholecystectomy. Duration of surgery was not different between the 2 groups.Laparoscopic common bile duct exploration with laparoscopic cholecystectomy is a single-stage procedure that has many advantages over endoscopic retrograde cholangiography/laparoscopic cholecystectomy if appropriate experience and when expertise is available. |
| Databáze: | OpenAIRE |
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