Mata QCJ, Farell RJ, Luna MJ, Cuevas OVJ, Sosa LAJ

Language: Spanish
References: 15
Page: 186-191
PDF size: 238.72 Kb.

ABSTRACT

ype: Case reports. Objective: Publish the experience of our center in the management of bile duct stones by laparoscopy as first-line treatment. Introduction: Laparoscopic bile duct exploration (LBDE) with choledochoscopy is as safe and efficient as endoscopic retrograde cholangiopancreatography (ERCP) to achieve the management of choledocholithiasis, as long as there are resources available, surgeons and centers specializing in advanced laparoscopic surgery. ERCP remains today the method of choice for the management of choledocholithiasis, but there is enough information in the international literature that supports the laparoscopic exploration of biliary tract as a method as effective as ERCP. Material and methods: During the period of 5 years (2008-2013), in the Hospital Central Sur de Alta Especialidad PEMEX the author performed in 28 patients, laparoscopic cholecystectomy and bile duct exploration assisted with intraoperative choledochoscopy. Results: LBDE was performed in 28 patients, with a success rate of stone extraction of 87%, average hospital stay of 4.5 days, 140 minutes mean operative time, 17% morbidity, mortality 0%, average bleeding 80 mL, 3-4 laparoscopic ports, and 46% of the times the extraction was achieved via cystic duct and the rest via main bile duct. Discussion: Our results can be compared with those already reported in different internationally series of cases. Conclusions: In order to solve the gallbladder disease and choledocholithiasis in a single surgical procedure, in a safe, effective way, and potentially shorter hospital stay and costs, cholecystectomy with laparoscopic bile duct exploration with intraoperative choledochoscopy is emerging as an excellent treatment option.

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