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Minilaparotomy for treatment of choledocholithiasis
V G Agadzhanov1, A M Shulutko, A M Kazaryan
1Department of Faculty Surgery N 2, IM Sechenov First Moscow State Medical University, Moscow, Russia.
Background:
Minilaparotomy has been reported to be an alternative minimally invasive option to laparoscopy. However, the quality of available data on the effectiveness of minilaparotomy to treat choledocholithiasis is poor.
Materials And Methods:
Two hundred and twenty-eight patients with choledocholithiasis underwent surgical exploration of the common bile duct via minilaparotomy from 1995 to 2010. Of these, 193 patients had choledocho/cholecystolithiasis with previous ineffective attempts at endoscopic clearance and 29 patients had choledocho/cholecystolithiasis without previous attempts at endoscopic clearance. Six other patients had recurrent/residual choledocholithiasis despite ineffective attempts at endoscopic clearance. Peri-operative adverse events were analyzed in accordance with the revised Satava classification for intra-operative events while post-operative complications were graded according to the Accordion classification.
Results:
Conversion was needed in 3.9% of procedures. The mean operative time was 86 min. Post-operative complications occurred in 6.1%, 2.2% of which were major (Accordion grade 4-6). Mortality was 0.9%.
Conclusion:
Minilaparotomy is an effective minimally invasive approach for the surgical treatment of choledocholithiasis. This approach could be considered as an alternative to the laparoscopic approach for surgical exploration of the common bile duct in patients with choledocholithiasis.