Laparoscopic endobiliary stenting: a simplified approach to the management of occult common bile duct stones

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
R D Fanelli, K S Gersin

Abstract

Three years ago we described laparoscopic placement of biliary stents as an adjunct to laparoscopic common bile duct exploration (LCBDE) in 16 patients. We now present a modification of our technique and experience with 48 additional patients. Laparoscopic cholecystectomy with intraoperative fluorocholangiography (LC/IOC) performed in 372 consecutive patients during a 36-month period revealed common bile duct stones (CBDS) in 48 patients (12.9%). In this series, LCBDE was not performed and no attempt was made to clear CBDS prior to transcystic stent placement. Stent placement added 9 to 26 minutes of operative time to LC/IOC alone. Forty-four patients (92%) were discharged after surgery and four (8%) were observed overnight. Outpatient endoscopic retrograde cholangiopancreatography 1 to 4 weeks later succeeded in clearing CBDS in all patients. All stents were retrieved without difficulty and 3- to 36-month follow-up demonstrates no surgical, endoscopic, or stent-related complications to date. Laparoscopic biliary stent placement for the treatment of CBDS is a safe, rapid, technically less challenging alternative to existing methods of LCBDE. It preserves the benefits of minimally invasive surgery for patients, and virtually ass...Continue Reading

Citations

Oct 2, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Everson L A ArtifonAtul Kumar
Aug 14, 2010·Surgical Endoscopy·D Wayne OverbyUNKNOWN Society of American Gastrointestinal and Endoscopic Surgeons
Jun 27, 2006·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Ka-Lung FokHeng-Tat Leong
May 11, 2019·Asian Journal of Endoscopic Surgery·Junfeng YangZhihai Mao
Jul 26, 2018·Journal of Pediatric Gastroenterology and Nutrition·Patrick C BonassoMelvin S Dassinger
Dec 24, 2017·Surgical Endoscopy·Marc ZereyDimitrios Stefanidis

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