Daniel Gomez, MD, FACS1, Luis F Cabrera, General Surgeon2, Andres Mendoza2, Ricardo Villarreal2, Mauricio Pedraza2, Jean Pulido2, Eric Vinck2, Sebastian Sanchez2. 1CPO, 2Bosque University
Background: Despite studies showing the effectiveness of common bile duct surgery (CBD) using laparoscopy in the international literature, In Colombia there are no series detailing the benefits and advantages of this approach as an alternative to open surgery in CBD stone obstruction. Here we present a case series on our experience with this technique on complex common bile duct stone obstruction using decompressive laparoscopy following failed ERCP.
Methods: During a time frame of 4 years from June 2014 to April 2018, 182 patients were taken to laparoscopic CBD decompression surgery due to complex stone obstruction. Records were reviewed and analyzed for demographic data, mean operative time, blood loss, intra or postoperative complications and hospital stay.
Results: All procedures were carried out successfully with no conversions registered, 100% of these procedures were CBD explorations with choledocotomy and primary duct closure, and in those patients with gallbladders, cholecystectomy was also performed (78%); all procedures using a laparoscopic approach. Surgery duration averaged 85 minutes, intraoperative bleeding averaged 15cc, no patients required additional surgery, there were no mortalities, none required ICU admission and average hospital stay was 5 days.
Conclusions: A laparoscopic approach to complex CBD stone obstruction with primary closure after failed ERCP is safe and effective, and in experienced hands offers advantages over open surgery and endoscopic techniques.
Key words: Laparoscopic; approach; bile duct; reconstruction; duct surgery
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 96015
Program Number: P257
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster