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Common bile duct exploration

Yogesh P Takalkar, Mandar S Koranne, Kumar S Vashist, Pranalee G Khedekar, Mahadeo N Garale, Sameer A Rege, Abhay N Dalvi
A 50-year-old female presented to us with features of obstructive jaundice. Investigations revealed cholelithiasis with single large impacted calculus in the common bile duct (CBD) and significant dilatation of extrahepatic biliary tree. Incidentally, the patient was also detected to have situs inversus totalis (SIT). Attempt at extraction of the calculus in the CBD by endoscopic retrograde cholangiography failed, and a 7F stent was placed. The patient was subjected to laparoscopic cholecystectomy, CBD exploration with the extraction of the offending calculus and laparoscopic choledochoduodenostomy (LCDD)...
July 2018: Journal of Minimal Access Surgery
Jisheng Zhu, Gen Sun, Le Hong, Xiaohua Li, Yong Li, Weidong Xiao
BACKGROUND: Although patients with previous upper abdominal surgery are no longer considered as a contraindication in laparoscopic surgery, laparoscopic common bile duct exploration (LCBDE) for these patients is still controversial. The aim of this study was to evaluate the safety and effectiveness of LCBDE for patients with previous upper abdominal surgery. METHODS: Two hundred and seventeen patients with common bile duct stones who underwent LCBDE in our institution from January 2010 to September 2017 were enrolled in the retrospective study...
June 4, 2018: Surgical Endoscopy
K B Deo, S Adhikary, S Khaniya, V C Shakya, C S Agrawal
Background: Laparoscopic common bile duct exploration has all the advantages of minimal access and is also the most cost effective compared to the other options. Objective: To study a profile on laparoscopic common bile duct exploration for a single common duct stone. Methods: A total of 30 consecutive patients with solitary common bile duct stone attending our hospital over a period of one year were enrolled in the study. Laparoscopic common bile duct exploration was done by transductal route in all the patients...
2018: Minimally Invasive Surgery
Fares E M Ali, Adel G Bakr, Amira M Abo-Youssef, Amany A Azouz, Ramadan A M Hemeida
AIM: The effects of diosmin (DS), pentoxifylline (PTX) and their combination on inflammatory response, oxidant/antioxidant balance, cytoglobin and cirrhotic reaction during bile duct ligation (BDL) were investigated and explored. MAIN METHODS: Fifty adult male Wistar albino rats were randomly allocated to five groups as following, sham: received vehicle only, BDL: subjected to common BDL without treatment, BDL plus DS: received 100 mg/kg/day orally, BDL plus PTX: received 50 mg/kg/day orally, BDL plus DS plus PTX: received DS and PTX in the same manner...
May 28, 2018: Life Sciences
Claudio Ricci, Nico Pagano, Giovanni Taffurelli, Carlo Alberto Pacilio, Marina Migliori, Franco Bazzoli, Riccardo Casadei, Francesco Minni
Importance: Several techniques are used for surgical treatment of gallstone disease with biliary duct calculi, but the safety and efficacy of these approaches have not been compared. Objectives: To compare the efficacy and safety of 4 surgical approaches to gallstone disease with biliary duct calculi. Data Sources: MEDLINE, Scopus, and ISI-Web of Science databases, articles published between 1950 and 2017 and searched from August 12, 2017, to September 14, 2017...
May 30, 2018: JAMA Surgery
Zhen-Peng Huang, Hu Qiu, Bao-Ping Yu
BACKGROUND/AIMS: Acute cholecystitis is a common gastrointestinal disorder, often characterized by acute cholecystitis with gallbladder motility disorder. Interstitial cells of Cajal (ICCs) are the pacemaker cells of gut motility in the gastrointestinal tract. Disruption of ICC function is related to motility disorders. The aim of this study was to explore the cellular and molecular mechanisms of ICCs in acute cholecystitis and after the resolution of acute inflammation. MATERIALS AND METHODS: Fifty adult guinea pigs were randomly divided into five groups: a sham-administered group (control group); two groups that were intraperitoneally administered an anti-polyclonal neutrophil (PMN) antibody 24 h before common bile duct ligation (CBDL); and two groups of guinea pigs that were subjected to CBDL without receiving the PMN antibody...
May 22, 2018: Cellular Physiology and Biochemistry
Liwei Pang, Jindong Yuan, Yan Zhang, Yuwen Wang, Jing Kong
Introduction: With the development of laparoscopic skills, the laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) has become the standard surgical procedure for choledocholithiasis. We usually use Hem-o-lok clips to control cystic duct and vessels, which is safe on most occasions and has few perioperative complications such as major bleeding, wound infection, bile leakage, and biliary and bowel injury. However, a rare complication of post-cholecystectomy clip migration (PCCM) increases year by year due to the advancement and development of LC, CBD exploration as well as the wide use of surgical ligation clips...
May 24, 2018: Journal of Minimal Access Surgery
Pablo Parra-Membrives, Darío Martínez-Baena, José Manuel Lorente-Herce, Ramón Martín-Balbuena
INTRODUCTION: In spite of the acquired experience with laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis management, there is still a risk of biliary leakage of 5% to 15% following choledochotomy closure. We evaluate the usefulness of fibrin-collagen sealants to reduce the incidence of biliary fistula after laparoscopic choledochorrhaphy. METHODS: We report a retrospective analysis of 96 patients undergoing LCBDE from March 2009 to March 2017, whose closure of the bile duct was completed by antegrade stenting and choledochorraphy or by performing a primary suture...
May 21, 2018: Cirugía Española
Chang Hwan Park
Common bile duct (CBD) stone is a relatively frequent disorder with a prevalence of 10-20% in patients with gallstones. This is also associated with serious complications, including obstructive jaundice, acute suppurative cholangitis, and acute pancreatitis. Early diagnosis and prompt treatment is the most important for managing CBD stones. According to a recent meta-analysis, endoscopic ultrasonography and magnetic resonance cholangiopancreatography have high sensitivity, specificity, and accuracy for the diagnosis of CBD stones...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Alejandro L Suarez, Huiping Xu, Peter B Cotton, B Joseph Elmunzer, David Adams, Katherine A Morgan, Douglas Sheafor, Gregory A Coté
BACKGROUND AND AIMS: ERCP has largely replaced common bile duct exploration for therapy of common bile duct pathology, yet its use as a purely diagnostic test has declined. Among inpatients, we hypothesized that timing between ERCP and cholecystectomy (CCY) have changed. The objectives were to measure temporal trends in the timing between inpatient ERCP and CCY, and to examine factors associated with delays. METHODS: We used the National Inpatient Sample between 1998 and 2013 to classify admissions for gallstone-related diagnoses who underwent inpatient CCY and ERCP by timing relative to CCY: within (±) 1 day, >2 days before, and >2 days after...
May 3, 2018: Gastrointestinal Endoscopy
Kyle Bender, Joel Lewin, Harriet O'Rourke, Freya C Hugh, Nicholas O'Rourke, Thomas J Hugh
BACKGROUND: The laparoscopic approach is considered the standard of care for cholecystectomy. Attempts to minimize incisions with single site and natural orifice approaches have shown promise but also have limitations. Technological advances have facilitated decreased port size, which may have a variety of benefits. The aim of this study was to determine the feasibility of an all 5-mm port approach for patients undergoing both elective and emergency laparoscopic cholecystectomy. METHODS: A consecutive series of laparoscopic cholecystectomies at three different hospitals using all 5-mm ports was prospectively evaluated...
April 24, 2018: ANZ Journal of Surgery
Imraan I Sardiwalla, Modise Z Koto, Neha Kumar, Moses A Balabyeki
BACKGROUND: Laparoscopic common bile duct exploration (LCBDE) is used to treat choledocholithiasis. Flexible choledochoscopy is usually performed; however, this instrument is fragile and liable to breakage. MATERIALS AND METHODS: Data were collected and reviewed retrospectively from a prospectively maintained database. All cases of attempted LCBDE with the rigid ureteroscope at the institution since January 2014 were included. Demographic characteristics, preoperative attempted endoscopic retrograde cholangiopancreatography (ERCP), size of the bile duct, findings at laparoscopy, use of drain or T-tube, conversions, and morbidity or mortality were documented...
April 20, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Lei Wang, Dachen Zhou, Hui Hou, Chunli Wu, Xiaoping Geng
To investigate the clinical application ofthe "three lines and one plane" concept as the anatomic landmarks during laparoscopic common bile duct exploration (LCBDE).From January 2014 to February 2017, 148 cases of LCBDE performed in the General Surgery Department of the 2nd affiliated Hospital of Anhui Medical University were recruited, and analyzed in this study. "Three lines and one plane" was applied as anatomical landmarks during LCBDE, and the perioperative clinical outcomes were analyzed...
April 2018: Medicine (Baltimore)
Ankush Sharma, Priyansh Jariwala, Navneet Kaur
The most common cause of gallbladder perforation is calculous cholecystitis. Rarer causes include trauma, iatrogenic injuries, biliary stasis and gall bladder ischemia. We report a case of gall bladder gangrene with perforation, secondary to extensive ascariasis. A 45-year-old woman presented with acute intestinal obstruction and jaundice. She had abdominal distension and right hypochondrial tenderness. Abdominal radiography showed dilated bowel loops and ultrasonogram showed worms in the small intestine and biliary tree...
January 1, 2018: Tropical Doctor
Ming-Yan He, Xia-Dong Zhou, Hao Chen, Peng Zheng, Fa-Zhan Zhang, Wei-Wei Ren
BACKGROUND: Common bile duct (CBD) stones may occur in up to 3%-14.7% of all patients with cholecystectomy. Various approaches of laparoscopic CBD exploration plus primary duct closure (PDC) are the most commonly used and the best methods to treat CBD stone. This systematic review was to compare the effectiveness and safety of the various approaches of laparoscopic CBD exploration plus PDC for choledocholithiasis. DATA SOURCES: Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) (case-control studies or cohort studies) were searched from Cochrane library (until Issue 2, 2015), Web of Science (1980-January 2016), PubMed (1966-January 2016), and Baidu search engine...
March 24, 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Matias E Czerwonko, Juan Pekolj, Pedro Uad, Oscar Mazza, Rodrigo Sanchez-Claria, Guillermo Arbues, Eduardo de Santibañes, Martín de Santibañes, Martín Palavecino
INTRODUCTION: In laparoscopic transcystic common bile duct exploration (LTCBDE), the risk of acute pancreatitis (AP) is well recognized. The present study assesses the incidence, risk factors, and clinical impact of AP in patients with choledocholithiasis treated with LTCBDE. METHODS: A retrospective database was completed including patients who underwent LTCBDE between 2007 and 2017. Univariate and multivariate analyses were performed by logistic regression. RESULTS: After exclusion criteria, 447 patients were identified...
April 3, 2018: World Journal of Surgery
S Hayakawa, K Sato, M Sakai, K Kutara, K Asano, T Watari
OBJECTIVES: To summarise CT cholangiography findings in dogs with gallbladder mucocoele. MATERIALS AND METHODS: Each of 10 dogs with gallbladder mucocoele underwent CT cholangiography using meglumine iotroxate before cholecystectomy. The following structures of the biliary system were evaluated: the right and left hepatic ducts, common hepatic duct, cystic duct, common bile duct and gallbladder. RESULTS: The hepatic duct, cystic duct, common bile duct and gallbladder were imaged by contrast-enhanced CT cholangiography...
March 30, 2018: Journal of Small Animal Practice
Anand Narayan Singh, Ragini Kilambi
BACKGROUND: The ideal management of common bile duct (CBD) stones associated with gall stones is a matter of debate. We planned a meta-analysis of randomized trials comparing single-stage laparoscopic CBD exploration and cholecystectomy (LCBDE) with two-stage preoperative endoscopic stone extraction followed by cholecystectomy (ERCP + LC). METHODS: We searched the Pubmed/Medline, Web of science, Science citation index, Google scholar and Cochrane Central Register of Controlled trials electronic databases till June 2017 for all English language randomized trials comparing the two approaches...
March 30, 2018: Surgical Endoscopy
Hengqing Zhu, Linquan Wu, Rongfa Yuan, Yu Wang, Wenjun Liao, Jun Lei, Jianghua Shao
BACKGROUND: Primary closure after laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) is a safe and effective approach for treating cholecystolithiasis with choledocholithiasis. The aim of this study was to evaluate the learning curve of performing primary closure after LC+LCBDE. METHODS: We retrospectively identified all patients who underwent primary closure after LC+LCBDE performed by a single surgeon from January 2009 to April 2015 in our institution, and analyzed preoperative, intraoperative, and postoperative data using the cumulative sum (CUSUM) analysis to evaluate the learning curve for this procedure...
March 30, 2018: Surgical Endoscopy
Thomas Togliani, Stefano Pilati, Andrea Lisotti, Giancarlo Caletti, Pietro Fusaroli
PURPOSE: Post-surgical upper gastrointestinal anatomy may hamper a complete bilio-pancreatic evaluation with a standard echoendoscope. The aim of this study was to assess the role of catheter probe extraductal ultrasound (EDUS) for the evaluation of the common bile duct (CBD) in patients who are status post-gastric surgery and who are suspected of having choledocholithiasis. METHODS: We retrospectively analyzed patients with a prior history of gastric surgery, who underwent EDUS for a suspicion of CBD obstruction...
March 29, 2018: Abdominal Radiology
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