4636 Single-stage laparoscopic cholecystectomy followed immediately by endoscopic sphincterotomy: experience with 57 patients. - 20/03/14
Résumé |
Background: the aim of the study was to establish the feasibility of intraoperative endoscopic sphincterotomy (IOES) when common bile duct (CBD) stones were discovered or strongly suspected on intra-operative cholangiography (IOC) during laparoscopic cholecystectomy (LC). Patients: among a total of 2193 laparoscopic cholecystectomies, we reviewed 57 patients who, from 1991 to 1999, had IOES done just after LC during the same anaesthetic session. Under fluoroscopic guidance, one group of 32 patients (Dijon) had IOES done in the prone position and a second group of 25 patients (Poitiers) in the left lateral position. Results: ES was successful in all cases (100%). CBD stones were definitively found in 49 cases (86%) but retrieved or liberated into the duodenum after IOES in only 46 cases (46/49, 93.9%). The mean duration time for the intra-operative endoscopic procedure was 28 minutes (range: 15-75). The short-term complications rate was 7 %. No long-term complication was encountered. The mean post-operative hospital stay was 5.3 days (range: 2-14). Conclusion: IOES performed after LC during the same anaesthetic session is feasible at low risk and with good results. It offers the opportunity to treat in one stage both cholecystolithiasis and choledocholithiasis without the need for surgical CBD exploration.
Le texte complet de cet article est disponible en PDF.Vol 51 - N° 4P2
P. AB189 - avril 2000 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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