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2016, Number 3

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Rev Mex Cir Endoscop 2016; 17 (3)

Laparoscopic cholecystectomy with intraoperative endoscopic retrograde cholangiopancreatography. A safe and effective therapeutic option for choledocholithiasis treatment

Alvarado GA, Hernández CJT, Álvarez MOA, Chávez AA, Lerma ARM, Arteaga VLR, López VA, Valencia JR, Velásquez MO, Pombo MJ

Language: Spanish
References: 30
Page: 132-138
PDF size: 387.55 Kb.


ABSTRACT

Introduction: The choledocholithiasis consists in bile duct obstruction. The approach goes from open surgical bile duct exploration, pre-surgical endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic exploration of the bile duct, as an alternative there is also the possibility of performing laparoscopic cholecystectomy with intraoperative ERCP. Objective: Our main goal in this study is to prove that laparoscopic cholecystectomy and intraoperative ERCP is a safe and useful option for choledocholithiasis. Material and methods: 41 patients were selected after being diagnosed with choledocholithiasis, and laparoscopic cholecystectomy with simultaneous intraoperatively ERCP was performed. Results were compared with the current literature. Results: Laparoscopic cholecystectomy with intraoperative ERCP were performed on 41 patients with successful outcomes in 95.12% (n = 38) and unsatisfactory in 4.88% (n = 2), common bile duct stones were extracted in 31p not being able to find them in 10 p. The intraoperative time average was 85.66 minutes (± 3.36 SD) with a minimum of 55 minutes up to a maximum of 160 minutes. There was no need for open conversion in any case and no postoperative complications were encountered such as bleeding, perforation or pancreatitis after ERCP. There was an average in hospital stay of 3.7 days (± 1.27 SD), with a minimum of two days to a maximum of seven days. Discussion: Our study shows a success rate with these simultaneous procedures of 95.2%, while the success rate of a laparoscopic exploration of biliary tract is 89.30% and laparoscopic cholecystectomy after ERCP of 91.4%. Conclusions: Laparoscopic cholecystectomy with intraoperative ERCP is a safe and effective option for choledocholithiasis treatment.


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