LAPAROSCOPIC COMMON BILE DUCT EXPLORATION: PATIENT SELECTION FOR NON- EXPERIENCED SURGEONS | ||
| The Egyptian Journal of Surgery | ||
| Volume 33, Issue 1, January 2014, Pages 14-18 PDF (514.84 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2014.366635 | ||
| Authors | ||
| Ehab El Hanafy; Emad Hamdy* ; Ayman El Nakeeb; Mohamad El Hemaly; Ehab Atef; Helmy Ezzat; Ali Salem; Tharwat Kandil | ||
| Gastroenterology Center, Mansoura University, Egypt | ||
| Abstract | ||
| Background and study aims: Gall stones (Cholelithiasis) are a common health problem worldwide. Common bile duct (CBD) stones are the second most frequent complication of cholelithiasis and occur in 10% to 15% of patients. Most laparoscopic surgeons prefer the “single-stage” laparoscopic approach to cholelithiasis and choledocholithiasis in an attempt to decrease the need for multiple procedures and their associated morbidity and mortality. This is a preliminary experience aiming at evaluation of laparoscopic common bile duct exploration in a selected group of patients with choledocholithiasis to choose good selection criteria. Patients / Material and Methods: From March 2011 to May 2013, fifty patients with common bile duct stones underwent laparoscopic CBD exploration in Gastro-enterology surgical center, Mansoura, Egypt. Results: Fifty patients with CBD stones underwent laparoscopic CBD exploration, with successful procedure in 47 cases and the remaining 3 cases required conversion to open surgery; Two patients underwent laparoscopic trans-cystic approach with successful CBD clearance in both patients as they have small stones below 0.5 cm. Forty-five patients required laparoscopic choledochotomy. Hospital morbidity occurred in 2 (4%) patients; one with minor bile leak which managed conservatively and one with missed CBD stone that required endoscopic stone removal 5 days postoperatively. There was no operative mortality. Conclusions: Laparoscopic CBD exploration is a feasible, safe and effective procedure that has a low morbidity and mortality rate. Patient selection is mandatory especially in the first few cases (during the learning curve) until experience is approached. | ||
| Keywords | ||
| Common bile duct stones; Laproscopic exploration; Non-experienced surgeons | ||
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