ArticleSurgical endoscopy2009
Why is there recurrence after transcystic laparoscopic bile duct clearance? Risk factor analysis.
Article in Surgical endoscopy, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Transcystic versus traditional laparoscopic common bile duct exploration: its advantages and a meta-analysis.Surgical endoscopy · 2018Pooled it
- Predictors for stone recurrence after a successful common bile duct surgical exploration for choledocholithiasis.Langenbeck's archives of surgery · 2022Article
- A meta-analysis of the use of intraoperative cholangiography; time to revisit our approach to cholecystectomy?Surgery open science · 2021Review
- Advances in Risk Factors for Recurrence of Common Bile Duct Stones.International journal of medical sciences · 2021Review
- How to choose the most appropriate technique for the single-stage treatment of cholecysto-choledocolithiasis?Gastroenterology report · 2019Article
- Laparoscopic transcystic common bile duct exploration: surgical indications and procedure strategies.Surgical endoscopy · 2018Article
- Single-stage procedure for the treatment of cholecysto-choledocolithiasis: a surgical procedures review.Therapeutics and clinical risk management · 2018Review
- Common bile duct exploration in an elderly Asian population.International surgery · 2015Article
- An audit of short- and long-term outcomes after laparoscopic removal of common bile duct stones in Finland.Surgical endoscopy · 2014Article
- Endoscopic Sphincterotomy Using the Rendezvous Technique for Choledocholithiasis during Laparoscopic Cholecystectomy: A Case Report.Case reports in gastroenterology · 2014Article
- Comparison of long-term outcomes after endoscopic sphincterotomy versus endoscopic papillary balloon dilation: a propensity score-based cohort analysis.Journal of gastroenterology · 2013Article
- Laparoscopic common bile duct exploration in patients with complicated cholecystitis: a safety and feasibility study.World journal of surgery · 2012Article
- Laparoscopic transcystic exploration for single-stage management of common duct stones and acute cholecystitis.Surgical endoscopy · 2012Article
- Cost-effective treatment of patients with symptomatic cholelithiasis and possible common bile duct stones.Journal of the American College of Surgeons · 2011Article
- Laparoscopic management of CBD stones: an Indian experience.Surgical endoscopy · 2011Article
- Laparoscopic exploration of the common bile duct with a rigid scope in patients with problematic choledocholithiasis.World journal of surgery · 2010Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimIncidence of common bile duct stones (CBDS) is approximately 10% in patients with symptomatic gallstones undergoing laparoscopic cholecystectomy. Transcystic laparoscopic common bile duct exploration (TC-CBDE) is safe and efficient in achieving bile duct clearance from stones, with a success rate of between 85% and 95%. The aim of this retrospective study is the evaluation of risk factors and recurrence in patients treated with TC-CBDS.
methodsFrom October 2003 until September 2007, 110 consecutive patients with common bile duct stones and gallbladder were included in the study. Average age was 64 years (range 21-82 years). The procedure was completed laparoscopically in 106 patients (96.4%): with TC-CBDE in 90 patients (85%), who are the object of this study; and with TC-CBDE + perioperative guide wire papillotomy ("rendezvous") in 16 cases (15%). In the 90 patients treated with TC-CBDE which we examined, the risk factors were: preoperative liver function tests, diameter of the common bile duct (normal 8 mm or less), number of stones (<or=3 or more), presence of stones with biliary sludge, and pre- or intraoperative diagnosis. Student's test was used for statistical analysis with a P value of < 0.05 defined as statistically significant.
resultThe conversion rate to open surgery was 3.6%. There were no mortalities. The average operative time was 115.6 min. The morbility rate was 7.7% with 4.8% local complications and 2.9% general complications. Average follow-up on 90 patients (after TC-CBDE) was 28 months (range 4.2-48 months). We found six recurrences (6.7%). The statistic analysis showed that only number of stones >3 with biliary sludge predicted a recurrence (p < 0.05) while the other factors did not show important clinical variables.
conclusionTC-CBDE is safe and effective in the majority of cases of CBDS. The incidence of recurrence is low but there are some risk factors, such as number of stones >3 with biliary sludge, which do not favor the successful outcome of the procedure. In such cases, it is essential that the TC-CBDE is integrated with other procedures which, although more complex, assure the clearance of the bile duct.
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