LAPAROSCOPIC COMMON BILE DUCT EXPLORATION: PATIENT SELECTION FOR NON- EXPERIENCED SURGEONS
El Hanafy, E., Hamdy, E., El Nakeeb, A., El Hemaly, M., Atef, E., Ezzat, H., Salem, A., Kandil, T. (2014). LAPAROSCOPIC COMMON BILE DUCT EXPLORATION: PATIENT SELECTION FOR NON- EXPERIENCED SURGEONS. EKB Journal Management System, 33(1), 14-18. doi: 10.21608/ejsur.2014.366635
Ehab El Hanafy; Emad Hamdy; Ayman El Nakeeb; Mohamad El Hemaly; Ehab Atef; Helmy Ezzat; Ali Salem; Tharwat Kandil. "LAPAROSCOPIC COMMON BILE DUCT EXPLORATION: PATIENT SELECTION FOR NON- EXPERIENCED SURGEONS". EKB Journal Management System, 33, 1, 2014, 14-18. doi: 10.21608/ejsur.2014.366635
El Hanafy, E., Hamdy, E., El Nakeeb, A., El Hemaly, M., Atef, E., Ezzat, H., Salem, A., Kandil, T. (2014). 'LAPAROSCOPIC COMMON BILE DUCT EXPLORATION: PATIENT SELECTION FOR NON- EXPERIENCED SURGEONS', EKB Journal Management System, 33(1), pp. 14-18. doi: 10.21608/ejsur.2014.366635
El Hanafy, E., Hamdy, E., El Nakeeb, A., El Hemaly, M., Atef, E., Ezzat, H., Salem, A., Kandil, T. LAPAROSCOPIC COMMON BILE DUCT EXPLORATION: PATIENT SELECTION FOR NON- EXPERIENCED SURGEONS. EKB Journal Management System, 2014; 33(1): 14-18. doi: 10.21608/ejsur.2014.366635

LAPAROSCOPIC COMMON BILE DUCT EXPLORATION: PATIENT SELECTION FOR NON- EXPERIENCED SURGEONS

The Egyptian Journal of Surgery
Volume 33, Issue 1, January 2014, Page 14-18  XML PDF (514.84 K)
Document Type: Original Article
DOI: 10.21608/ejsur.2014.366635
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Authors
Ehab El Hanafy; Emad Hamdy email ; 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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