Five-Year Experience with Transcystic Laparoscopic Common Bile Duct Exploration

Area of Science:

• Gastroenterology
• Hepatobiliary Surgery
• Minimally Invasive Surgery

Background:

• Common bile duct (CBD) stones often accompany cholecystitis, presenting treatment challenges.
• Management options include single-stage CBD exploration during cholecystectomy or a two-stage approach involving endoscopic stone extraction.
• The optimal management strategy for CBD stones remains under investigation.

Purpose of the Study:

• To evaluate the outcomes of transcystic laparoscopic common bile duct exploration (LCBDE) for managing CBD stones.
• To assess the efficacy and safety of the transcystic approach in a clinical setting.

Main Methods:

• A retrospective review was conducted on patients who underwent transcystic LCBDE between 2015 and 2019.
• Data collected included patient demographics, procedural details, operative time, length of stay, and complications.
• Intraoperative cholangiograms were used to assess stone clearance.

Main Results:

• Transcystic LCBDE was performed on 106 patients over a 5-year period.
• Successful clearance of CBD stones via the transcystic approach was achieved in 86% of patients not undergoing preoperative ERCP.
• The procedure avoided choledochotomy in all cases, with low complication rates (e.g., wound infection, pancreatitis).

Conclusions:

• Transcystic LCBDE is a safe and effective treatment for CBD stones.
• This minimally invasive technique reduces the need for choledochotomy and can decrease the requirement for additional procedures.
• The transcystic approach offers a valuable alternative in the management of CBD stones.