Initial Experience with Disposable Single-Use Cholangioscope During Laparoscopic Common Bile Duct Exploration.

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery

Background:

• Laparoscopic common bile duct exploration (LCBDE) is a cost-effective alternative to ERCP for choledocholithiasis.
• LCBDE can be technically challenging, and a disposable single-use cholangioscope (DSUC) offers advantages like avoiding choledochotomy.

Purpose of the Study:

• To evaluate the safety and efficacy of LCBDE using a DSUC for managing choledocholithiasis.
• To assess outcomes including stone clearance, operative time, and hospital stay.

Main Methods:

• Retrospective chart review of 12 patients undergoing concurrent LC and LCBDE with DSUC (SpyGlass™ Discover) from 2021-2023.
• Diagnosis of choledocholithiasis was made preoperatively or via intraoperative cholangiogram (IOC).
• Primary endpoint was successful clearance of biliary duct stones.

Main Results:

• Ten of 12 patients had choledocholithiasis; complete stone clearance was achieved in all 10.
• Mean operative time was 189 minutes; mean postoperative hospital stay was 1 day.
• No intraoperative complications or repeat procedures were needed; one superficial surgical site infection occurred.

Conclusions:

• LCBDE with a DSUC is a safe and efficacious technique for clearing common bile duct stones.
• This approach can be particularly useful for surgeons managing choledocholithiasis concurrently with cholecystectomy, reducing hospital stay and costs.