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Laparoscopic common bile duct exploration: long-term outcome.
D I Giurgiu1, D R Margulies, B J Carroll
1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif., USA.
Archives of Surgery (Chicago, Ill. : 1960)
|August 12, 1999
Summary
Transcystic laparoscopic common bile duct exploration (LCBDE) is a safe and effective treatment for common bile duct stones, significantly reducing pain and other symptoms. Most patients report high satisfaction with the procedure, with minimal long-term complications.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Biliary Tract Surgery
Background:
- Common bile duct stones pose a significant clinical challenge.
- Laparoscopic cholecystectomy is a standard procedure for gallstones.
- Transcystic laparoscopic common bile duct exploration (LCBDE) with biliary endoscopy is an evolving technique.
Purpose of the Study:
- To evaluate the long-term clinical outcomes and patient satisfaction following LCBDE.
- To assess the efficacy and safety of LCBDE in treating common bile duct stones.
Main Methods:
- A prospective cohort study was conducted involving 217 patients with common bile duct stones.
- Transcystic LCBDE with choledochoscopy was performed.
- Patient-reported outcomes, including symptoms and satisfaction, were assessed via mailed surveys with a mean follow-up of 60 months.
Main Results:
- LCBDE was successful in most patients, with a low rate of conversion to ERCP (3%).
- Significant reductions in preoperative abdominal pain and non-pain symptoms were observed postoperatively (P = .001).
- 95% of patients reported being satisfied or mostly satisfied with the LCBDE procedure.
Conclusions:
- Transcystic LCBDE is a safe and effective treatment for common bile duct stones, offering excellent long-term outcomes.
- The procedure leads to significant symptom improvement and high patient satisfaction.
- LCBDE is associated with minimal morbidity, including no late recognition of retained stones or bile duct strictures.