Intraoperative endoscopist-controlled guide wire cannulation technique sphincterotomy during laparoscopic...

Area of Science:

• Gastroenterology
• Surgical Innovation
• Minimally Invasive Procedures

Background:

• Intraoperative endoscopic sphincterotomy (IOES) is favored over preoperative methods for common bile duct (CBD) stones.
• This study details a novel IOES technique in the supine position during laparoscopic cholecystectomy (LC).

Purpose of the Study:

• To evaluate the efficacy and safety of the intraoperative supine endoscopic sphincterotomy by endoscopist-controlled guide wire cannulation (ISEEG) technique.
• To assess the ISEEG technique as a single-stage treatment for CBD stones during LC.

Main Methods:

• Retrospective analysis of 36 patients undergoing LC with IOES (ISEEG technique).
• Patients presented with acute biliary colic and jaundice, suspected choledocholithiasis.
• Intraoperative cholangiogram confirmed CBD stones prior to the ISEEG procedure.

Main Results:

• Successful CBD catheterization in 94.44% (34/36) of patients.
• 100% stone clearance rate achieved with the ISEEG technique.
• Median procedure time was 9 minutes; average hospital stay was 4.8 days.
• Postoperative pancreatitis occurred in 8.33% of patients; no procedure-related mortality.

Conclusions:

• LC combined with the ISEEG technique is an effective single-stage treatment for CBD stones.
• The ISEEG technique demonstrates high efficacy, excellent stone clearance, and low morbidity.
• Expert endoscopist performance is key for successful outcomes.