Related Experiment Video
Updated: May 23, 2025
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Feasibility of cholecystectomy in patients with silent common bile duct stones cohort prospective single arm
Ahmad A Maklad1,2, Mahmoud Eltantawy3, Mohammed Siam3
1Department of General Surgery, Faculty of Medicine, Suez university, Suez city, 43221, Egypt. maklad2006@yahoo.com.
Insights
A wait-and-see strategy for silent common bile duct stones (CBDS) during laparoscopic cholecystectomy (LC) is feasible. Most patients with gallbladder stones and silent CBDS can safely undergo LC without immediate intervention for CBDS.
Area of Science:
- Gastroenterology
- Surgical Management
- Hepatobiliary Surgery
Background:
- Management of concurrent gallbladder stones and silent common bile duct stones (CBDS) remains debated.
- Limited evidence exists for proactive CBD clearance before or during cholecystectomy.
Purpose of the Study:
- To evaluate the feasibility of a wait-and-see strategy for silent CBDS in patients undergoing laparoscopic cholecystectomy (LC).
Main Methods:
- Retrospective study of 60 patients with gallbladder stones and silent CBDS undergoing LC.
- Patients were observed using a wait-and-see approach for silent CBDS.
Main Results:
- All 60 patients completed LC laparoscopically.
- Only 3.3% developed symptomatic CBDS, managed medically.
- 26.7% experienced spontaneous resolution of CBDS during follow-up.
Conclusions:
- Laparoscopic cholecystectomy is safe for patients with gallbladder stones and asymptomatic CBDS.
- A wait-and-see strategy for silent CBDS is associated with acceptable short-term outcomes.
Background:
The management of patients with concomitant gallbladder stones with silent CBDS still involves a wide range of debates, and there is little evidence regarding the recommendation of CBD clearance either before cholecystectomy or in the same session. In this study, we aimed to discuss the feasibility of performing LC with a wait-and-see strategy for patients with silent CBS.
Method:
Patients with silent CBDS identified during preoperative examinations for gallbladder stones were studied for the feasibility of performing LC with a wait-and-see strategy for silent CBS.
Results:
Sixty patients who presented with gallbladder stones with silent CBDS underwent LC between February 2023 and July 2023. Seventeen patients (28.3%) underwent laparoscopic acute cholecystectomy, and 43 (71.7%) patients underwent laparoscopic elective cholecystectomy; all of these procedures were completed laparoscopically. Two patients (3.3%) developed symptomatic CBDS, both of whom were treated medically without intervention. Sixteen patients (26.7%) experienced spontaneous CBDS during the follow-up period.
Conclusion:
Patients who present with symptomatic gall bladder stones either acutely or electively with asymptomatic CBDS can undergo laparoscopic cholecystectomy without suffering from CBDS with acceptable short-term outcomes.
Trial Registration:
This study was registered at Suez med - IRB office under trial registration no. 6 and registered at clinicaltrials.gov (NCT06349876) in 31/3/2024.
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