Sergio Rojas-ortega, MD, Emina Pasic, MD, Gerardo Reed, MD, Anuar Flores-simon, Cris Gomez, RN, Rachid Cesin, MD. HOSPITAL ANGELES PUEBLA
Management of patients with common bile duct stones should be in only one session. For the past two decades this has been our practice in the majority of cases of patients undergoing laparoscopic cholecystectomy (LC). Only in a small group of patients we still depend on endoscopic sphincterotomy(ES)
MATERIAL and METHODS: From 1992 to 2016 we have performed 1,150 laparoscopic cholecystectomies for symptomatic gallstone disease. We found 115 patients (10%) with common bile duct stones with routine dynamic cholangiography. All of them were submitted to common bile duct exploration during the laparoscopy with flexible choledochoscopy: trans-cystic or trans-choledochal.
RESULTS: 108 patients (94%) were treated successfully with extraccion of common bile duct stones during LC. 80 cases (74%) were trans-cystic and 29 (26%) were trans-choledochal bile duct exploration using wire basket and flexible choledochoscopy. In only 7 patients (6%) we had to convert to open surgery or refer to post-op ES. Morbidity in 5 patients (4.6%) without bile leaks and mortality 0%. Hospital stay of 48 hrs.
CONCLUSION: Must of the patients (94%) were treated successfully with the laparoscopic aproach either trans-cystic or trans-choledochal without any major complications. We strongly belive that one session for the management of choledocholithiasis is the best treatment .
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77386
Program Number: P114
Presentation Session: Poster (Non CME)
Presentation Type: Poster