Laparoscopic Common Bile Duct Exploration: 9 Years Experience from a Single Center

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Biliary Tract Surgery

Background:

• Common bile duct stones (CBDS) pose a significant clinical challenge.
• Traditional management often involves open procedures or multiple stages.
• Laparoscopic common bile duct exploration (LCBDE) offers a less invasive alternative.

Purpose of the Study:

• To evaluate the safety and feasibility of a single-stage laparoscopic common bile duct exploration (LCBDE) with T-tube placement for managing common bile duct stones (CBDS).

Main Methods:

• A prospective study of 99 patients undergoing LCBDE with T-tube insertion between 2005 and 2010.
• Standardized follow-up through patient record review was conducted.
• The procedure involved cholangiotomy with T-tube placement in one session.

Main Results:

• No severe intraoperative complications were observed.
• The mean operative time was 194 minutes, with a mean postoperative hospital stay of 4.8 days.
• A low rate of retained stones (2%) and minor bile leakage (2%) was reported, with no major adverse events like peritonitis, fistula, pancreatitis, or cholangitis.

Conclusions:

• LCBDE with T-tube placement is a safe and feasible option for CBDS management when performed by experienced surgeons.
• The technique is particularly advantageous for patients with multiple or large common bile duct stones.
• The risk of retained stones and post-operative stricture is minimal.