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Updated: May 9, 2026
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Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Preoperative factors predicting poor outcomes following laparoscopic choledochotomy: a multivariate analysis study
Xiaoming Ye1, Xiaoming Hong, Kaiyuan Ni
1Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yinzhou Second Hospital, Ningbo, China. xiaomingzj@163.com
Summary
Laparoscopic choledochotomy (LC) for common bile duct stones carries risks. High total bilirubin and medical risk factors predict adverse outcomes, helping stratify patient risk for this complex procedure.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Patient Safety
Background:
- Laparoscopic choledochotomy (LC) is a procedure for common bile duct stones.
- It presents higher morbidity compared to the transcystic approach.
- Risk factors for adverse outcomes in LC require investigation.
Purpose of the Study:
- To identify risk factors for adverse outcomes in laparoscopic choledochotomy (LC).
- To develop a predictive model for adverse events in LC patients.
Main Methods:
- Retrospective analysis of 201 patients undergoing LC.
- Logistic regression models assessed adverse outcomes (complications, conversion, failed clearance).
- Receiver operating characteristic curve analysis evaluated diagnostic accuracy.
Main Results:
- Adverse outcomes occurred in 23.9% of patients.
- Total bilirubin (BIL) and medical risk factors (MRFs) significantly predicted adverse outcomes.
- A predictive model stratified patients into low-risk (12% adverse outcomes) and high-risk (50.7% adverse outcomes) groups.
Conclusions:
- Elevated total bilirubin and the presence of medical risk factors are key predictors of adverse outcomes in LC.
- These factors aid in stratifying patients undergoing LC for common bile duct stones.
- Risk stratification can potentially improve patient management and outcomes.