The efficacy and safety of laparoscopic common bile duct exploration and cholecystectomy for the treatment of difficult common bile duct stones combined with gallstones: a multicenter retrospective study

Langenbecks Arch Surg. 2023 May 15;408(1):195. doi: 10.1007/s00423-023-02923-3.

Abstract

Purpose: To analyze the benefits of laparoscopic common bile duct exploration and laparoscopic cholecystectomy (LCBDE + LC) versus endoscopic retrograde cholangiopancreatography and/or endoscopic sphincterotomy following laparoscopic cholecystectomy (ERCP/EST + LC) for difficult common bile duct stones combined with gallstones.

Methods: A retrospective analysis of consecutive patients with difficult common bile duct stones combined with gallstones in three hospitals from January 2016 to January 2021 was performed.

Results: ERCP/EST + LC contributed to reducing postoperative drainage time. However, LCBDE + LC showed a higher rate of complete clearance, along with lower postoperative hospital stays, expenses and incidence of postoperative hyperamylasemia, pancreatitis, re-operation and recurrence. In addition, LCBDE + LC showed safe and feasible performance in the elderly and patients with previous upper abdominal surgery.

Conclusion: It is an effective and safe method for LCBDE + LC for difficult common bile duct stones combined with gallstones.

Keywords: Common bile duct stones; Endoscopic retrograde cholangiopancreatography; Endoscopic sphincterotomy; Gallstones; Laparoscopic cholecystectomy; Laparoscopic common bile duct exploration.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Cholangiopancreatography, Endoscopic Retrograde / methods
  • Cholecystectomy
  • Cholecystectomy, Laparoscopic* / adverse effects
  • Cholecystectomy, Laparoscopic* / methods
  • Choledocholithiasis* / complications
  • Choledocholithiasis* / surgery
  • Common Bile Duct / surgery
  • Gallstones* / complications
  • Gallstones* / surgery
  • Humans
  • Retrospective Studies