ReviewSurgical endoscopy2021
Lessons learnt from the first 200 unselected consecutive cases of laparoscopic exploration of common bile duct stones at a district general hospital.
Review in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Primary duct closure versus T-tube drainage after laparoscopic common bile duct exploration: a meta-analysis.Journal of Zhejiang University. Science. B · 2021Pooled it
- Step-by-step laparoscopic transcystic common bile duct exploration in choledocholithiasis: technical tips, special scenarios, lessons and results from over 100 cases.Surgical endoscopy · 2026Article
- Safety and outcomes of laparoscopic bile duct exploration: a UK-wide multi-centre study (R-ALiCE).Surgical endoscopy · 2026Article
- Re-do laparoscopic common bile duct exploration for recurrent common bile duct stones: a single-center retrospective cohort study.Annals of surgical treatment and research · 2025Article
- Laparoscopic common bile duct exploration for choledocholithiasis on an emergency setting.Surgical endoscopy · 2025Article
- Routine single-incision laparoscopic common bile duct exploration with concomitant cholecystectomy for elderly patients: a 6-year retrospective comparative study.Surgical endoscopy · 2024Observational
- Review
- Analysis of Efficacy and Safety of Laparoscopy Plus Choledochoscopy Combined With Holmium Laser Lithotripsy for Choledocholithiasis and Hepatolithiasis.Gastroenterology research · 2024Article
- Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysis.Frontiers in surgery · 2024Article
- Index admission vs elective laparoscopic common bile duct exploration: a district general hospital experience over 6 years.Langenbeck's archives of surgery · 2023Article
- [Clinical effect of laparoscopic transcystic drainage combined with common bile duct exploration for the patients with difficult biliary stones].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2022Article
- The single-stage management of bile duct stones is underutilised: A prospective multicentre cohort study with a literature review.Annals of hepato-biliary-pancreatic surgery · 2022Article
- Optimal treatment for concomitant gallbladder stones with common bile duct stones and predictors for recurrence of common bile duct stones.Surgical endoscopy · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of choledocholithiasis evolves with diagnostic imaging and therapeutic technology, facilitating a laparoscopic approach. We review our first 200 cases of laparoscopic exploration of the common bile duct, highlighting challenges and lessons learnt.
methodsWe retrospectively studied the first 200 cases of laparoscopic cholecystectomy with common bile duct exploration between 2006 and 2019. The database contains demographics, clinicopathological characteristics, diagnostic modalities, operative techniques, duration and outcomes.
resultsWe compared two approaches: transcystic vs. transcholedochal in our 200 cases. Choledocholithiasis was suspected preoperatively in 163 patients. 21 cases found no stones. Of the remainder, 111/179 cases were completed via the transcystic route and the remaining were completed transcholedochally (68/179); 25% of the transcholedochal cases were converted from a transcystic approach. CBD diameter for transcystic route was 8.2 vs. 11.0 mm for transcholedochal. Total clearance rate was 84%. Retained or recurrent stones were noted in 7 patients. Length of stay was 5.8 days, 3.5 days in the transcystic route vs. 9.4 days after transcholedochal clearance. Eight patients required re-operation for bleeding or bile leak. No mortalities were recorded in this cohort, but 2 cases (1%) developed a subsequent CBD stricture.
conclusionConcomitant laparoscopic common bile duct clearance with cholecystectomy is feasible, safe and effective in a district general hospital, despite constraints of time and resources. The transcystic route has a lower complication rate and shorter hospital stay, and hence our preference of this route for all cases. Advancements in stone management technology will allow wider adoption of this technique, benefitting more patients.
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