Laparoscopic trans-cystic-duct common-bile-duct exploration

✍ Scribed by E. H. Phillips; R. J. Rosenthal; B. J. Carroll; M. J. Fallas

• Publisher: Springer
• Year: 1994
• Tongue: English
• Weight: 538 KB
• Volume: 8
• Category: Article
• ISSN: 0930-2794
• DOI: 10.1007/bf00187342

✦ Synopsis

One thousand seventy-one consecutive laparoscopic cholecystectomies were performed. Routine cholangiography was employed with a 99% success rate. One hundred thirty patients were found to have common duct stones (CBDS). In 48 (37%) patients they were unsuspected. One hundred eleven patients underwent attempted trans-cystic-duct extraction techniques (TCD-CBDE). One hundred three (93%) were successful. The following techniques were employed: 101--biliary endoscopy, 23--ampullary balloon dilation, 2--fluoroscopic basket retrieval.

The average operative time was 136 min. The average postsurgical stay was 3.7 days. There were 19 (17%) complications--6 (5%) major. There were 4 retained stones (2 intentional) and 1 death. Patients over 65 years of age had more complications and patients with unsuspected CBDS under 65 years of age had the fewest.

TCD-CBDE is a safe, effective way to extract common duct calculi. Endoscopy and basket stone retrieval was the primary technique employed.