Transcystic Choledochoscopy Utilizing a Disposable Choledochoscope: How We Do It

Area of Science:

• Surgical Gastroenterology
• Minimally Invasive Surgery
• Biliary Tract Disease

Background:

• Biliary disease, particularly choledocholithiasis, is a frequent condition encountered in general surgery practice.
• While endoscopic retrograde cholangiopancreatography (ERCP) is commonly favored, laparoscopic common bile duct exploration (LCBDE) remains underutilized.
• Choledocholithiasis management often involves advanced imaging and endoscopic interventions.

Purpose of the Study:

• To review current literature on laparoscopic common bile duct exploration (LCBDE).
• To highlight the benefits and clinical outcomes of LCBDE compared to ERCP.
• To provide guidance for surgeons considering LCBDE implementation.

Main Methods:

• A literature summary was conducted using a PubMed search.
• The review focused on the latest data and clinical outcomes of LCBDE.
• A procedural video demonstrating LCBDE was created.

Main Results:

• LCBDE demonstrates equivalent clinical outcomes to ERCP for choledocholithiasis.
• LCBDE is associated with a shorter length of hospital stay and reduced healthcare costs.
• The procedure is effective even in patients with altered anatomy, such as post-Roux-en-Y gastric bypass.

Conclusions:

• LCBDE is an underutilized yet effective treatment for common bile duct stones.
• Patient benefits include avoiding additional procedures, shorter hospital stays, higher success rates, and lower costs.
• LCBDE offers a valuable alternative to ERCP, particularly in specific patient populations.