Laparoscopic endobiliary stenting significantly improves success of postoperative endoscopic retrograde cholangiopancreatography in low-volume centers

Surgical Endoscopy
R D FanelliM T Mainella

Abstract

Occult common bile duct stones (CBDS) discovered during laparoscopic cholecystectomy with intraoperative cholangiography are most often managed by postoperative endoscopic retrograde cholangiopancreatography (ERCP). Expert endoscopists at high-volume centers achieve common bile duct cannulation in nearly all patients undergoing ERCP, but cannulation rates of less than 80% have been observed in low-volume centers. As many as 20% of patients with CBDS referred for postoperative ERCP in low-volume centers may require repeated attempts at ERCP, referral to a high-volume center, percutaneous transhepatic techniques, or reoperation for clearance of CBDS when postoperative ERCP fails. Laparoscopic cholecystectomy with intraoperative cholangiography performed in 511 consecutive patients over 80 months at a community hospital showed occult CBDS in 66 patients (12.9%). Laparoscopic endobiliary stent placement was successful in 65 patients (98.5%). As part of an earlier study, 16 patients underwent laparoscopic common bile duct exploration with clearance of CBDS before stent placement. Laparoscopic endobiliary stent placement failed in one patient for whom CBDS were cleared with intraoperative ERCP. Initial postoperative ERCP was successf...Continue Reading

Citations

Aug 14, 2010·Surgical Endoscopy·D Wayne OverbyUNKNOWN Society of American Gastrointestinal and Endoscopic Surgeons
Oct 2, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Everson L A ArtifonAtul Kumar
Jan 27, 2005·Gastrointestinal Endoscopy·Martin L Freeman, Nalini M Guda
Jun 27, 2006·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Ka-Lung FokHeng-Tat Leong
Sep 15, 2004·Gastrointestinal Endoscopy Clinics of North America·Brian J Dunkin
Sep 25, 2014·Surgical Endoscopy·Matthew LyonHarish Kumar
Jun 2, 2009·International Journal of Surgery·Abdel Hamid GhazalHassan El-Bahrawy

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