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Laparoscopic common bile duct exploration after failed endoscopic stone extraction

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Abstract

Background

Our objective was to present the technical aspects and results of laparoscopic common bile duct (CBD) exploration following failed endoscopic stone extraction.

Method

From April 1997 to December 2006, 32 patients were referred to us after unsuccessful attempts at endoscopic CBD stone extraction. Transcholedochal laparoscopic CBD exploration was used in all patients. Previous operations, several pathologic entities, and stone impaction were studied as potential predictors of failure of the laparoscopic approach.

Results

Previous operations, cholangitis, anatomic abnormalities, and stone impaction were the principal reasons for failure of endoscopic retrograde cholangiopancreatography (ERCP). Stone extraction under direct laparoscopic choledochotomy was achieved in 20 of 31 patients (64.51%). Biliary stents were inserted in 7 patients (21.8%) and T tubes were placed in 21 patients (65.6%). Five laparoscopic choledochoduodenostomies were performed. There were 11 conversions to open surgery. Morbidity was 12.5%.

Conclusions

Laparoscopic choledochotomy is an efficacious procedure in dealing with unsuccessful endoscopic CBD clearance.

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Abbreviations

CBD:

common bile duct

LC:

laparoscopic cholecystectomy

ERCP:

endoscopic retrograde cholangiopancreatography

ES:

endoscopic sphincterotomy

PTBD:

percutaneous transhepatic biliary drainage

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Authors and Affiliations

  1. 2nd Surgical Department of Korgialenion – Benakion, Red Cross Hospital, 11 Mantzarou str., Neo Psychiko, 15451, Athens, Greece

    Constantine Karaliotas, George Sgourakis, Nickolaos Papaioannou & Constantine Lilis

  2. Department of Gastroenterology of Korgialenion – Benakion, Red Cross Hospital, Athens, Greece

    Constantine Goumas

  3. 1st Propaedeutic Surgical Department of National Kappodistrian University, Hippocration Hospital, Athens, Greece

    Emmanouel Leandros

Authors
  1. Constantine Karaliotas
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  2. George Sgourakis
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  3. Constantine Goumas
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  4. Nickolaos Papaioannou
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  5. Constantine Lilis
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  6. Emmanouel Leandros
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Corresponding author

Correspondence to George Sgourakis.

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Karaliotas, C., Sgourakis, G., Goumas, C. et al. Laparoscopic common bile duct exploration after failed endoscopic stone extraction. Surg Endosc 22, 1826–1831 (2008). https://doi.org/10.1007/s00464-007-9708-8

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  • DOI: https://doi.org/10.1007/s00464-007-9708-8

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