期刊
JSLS-JOURNAL OF THE SOCIETY OF LAPAROENDOSCOPIC SURGEONS
卷 18, 期 4, 页码 -出版社
SOC LAPAROENDOSCOPIC SURGEONS
DOI: 10.4293/JSLS.2014.00277
关键词
Common bile duct stones; Biliary drainage; Laparoscopy; Choledocholithiasis
类别
Background: To date, the management of common bile duct stones (CBDs) is still controversial. If laparoscopic exploration is performed and biliary decompression is needed after stone removal, the placement of a laparoscopic transpapillary stent shows promising results in avoiding T-tube-related complications. Methods: Between January 2007 and May 2012, a series of 48 patients who underwent biliary decompression after laparoscopic common bile duct exploration (LCBDE) to treat choledocholithiasis was retrospectively analyzed. The results in patients with transpapillary stent placement (TS = 35) were compared with those who had an external biliary drainage (EBD = 13). Results: LCBDE and TS placement was achieved either by a choledochotomy or through the cystic duct. There was no mortality in our series. Patients with an external biliary drainage (EBD) had more surgery-related complications (P < .0001) and a longer hospital stay (P = .03). Postoperative ERCP to remove the TS was successful in all cases. Conclusion: Laparoscopic TS is a safe method in the treatment of selected patients with CBD stones that can be achieved without having to perform a choledochotomy. Because of the lower morbidity and the shorter hospital stay compared with EBD, it should be considered as a first approach whenever biliary decompression is needed after LCBDE.
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