Majid Kianmajd, DO, Patrick R Reardon, MD, Lee Morris, MD. Houston Methodist
The treatment algorithm for patients presenting with common bile duct stones are varied and most patients will be referred to ERCP prior to cholecystectomy. Aside from ERCP, there are multiple other laparoscopic techniques described for choledocholithiasis with the advantage of removing the stones concurrently with cholecystectomy. Studies have shown that laparoscopic bile duct exploration is as safe and efficient as ERCP in clearing biliary stones versus pre or post-operative ERCP. Meta analysis of comparison studies has shown that laparoscopic cholecystectomy with bile duct exploration showed the most success for overall bleeding, operative time, and least total cost compared with pre, intra-operative, or post-operative ERCP. Each patient must be evaluated individually for what is safest, most efficient, and available to the patient at their institution. Laparoscopic common duct exploration require specific technical skills and equipment likely seen at academic centers with advanced laparoscopic and endoscopic training – which is also more likely where a patient with complex presentation will be referred. Practitioners should keep in mind that laparoscopic common duct exploration is a safe and feasible option, when available.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94005
Program Number: V024
Presentation Session: HPB Videos
Presentation Type: Video
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