A novel laparoscopic transcystic approach using an ultrathin choledochoscope and holmium laser lithotripsy in the management of cholecystocholedocholithiasis: An appraisal of their safety and efficacy - 20/03/18
, Yang Liu a, Hao Jiang b, Tao Yang a, Bin Liang a, Jian-Ping Zeng a, Jia-Hong Dong aAbstract |
Background |
Although laparoscopic transcystic common bile duct exploration (LTCBDE) is the preferred approach for CBD stone clearance, the success rate can vary between 55% and 85%. This study evaluated if ultrathin choledochoscope and holmium laser lithotripsy could improve the success rate of LTCBDE.
Methods |
Records of 126 patients (average age, 46.1 ± 13.8 years) with cholecystocholedocholithiasis treated with laparoscopic cholecystectomy (LC) and LTCBDE were retrospectively reviewed.
Results |
LC+LTCBDE was performed successfully in 118 of 126 patients, with a surgical success rate of 93.7%. An ultrathin choledochoscope was used in 75 (63.5%) patients, and holmium lithotripsy was performed in 38 (32.2%) patients. The stone clearance rate was 99.2% (117/118). No significant complications occurred. One hundred (84.7%) patients had excellent and 13 (11%) had good outcomes for an overall success rate (excellent plus good) of 95.7%.
Conclusion |
Ultrathin choledochoscope and holmium laser lithotripsy can improve the surgical outcomes of LC+LTCBDE with minimal complications.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | An ultrathin choledochoscope and holmium laser lithotripsy (HLL) is effective for treating cholecystocholedocholithiasis. |
• | Laparoscopic transcystic common bile duct exploration (LTCBDE) outcomes are improved with an ultrathin choledochoscope/HLL. |
• | Use of an ultrathin choledochoscope/HLL is associated with minimal complications when performing LTCBDE. |
Keywords : Cholecystolithiasis, Choledocholithiasis, Laparoscopic transcystic common bile duct exploration, Ultrathin choledochoscope, Holmium laser lithotripsy
List of abbreviations : CBD, LTCBDE, LC, LC, ERCP, EST
Mappa
Vol 215 - N° 4
P. 631-635 - aprile 2018 Ritorno al numero
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