Minimally invasive treatment of choledocholithiasis

Myhaylo Nychytaylo, MD, Prof, Petro Ogorodnik, MD, Oleksandr Lytvynenko, MD, Anatolii Skums, MD, Andrey Deynychenko, PhD, Oleksandr Lytvyn, PhD, Valeriy Bilyaev

National Institute of Surgery and Transplantology named by A.A. Shalimov

Since the introduction of laparoscopic techniques, the management of patients with choledocholithiasis is in a stage of evolution. Over a 18 – year period, from 1994 to 2012, 1965 patients presented with common bile duct (CBD) stones and calculous cholecystitis. Double stage treatment of choledocholithiasis by way of laparoscopic cholecystectomy following endoscopic sphincterotomy and stone removal was performed in 1480 cases. The following endoscopic procedures were performed: mechanical lithotripsy – in 455(30,7%), and removal of CBD stones with Dormia bascet in 1025 (69,3%) cases. 485 patients underwent laparoscopic cholecystectomy and common bile duct exploration simultaneously. Transcystic approach for CBD exploration was performed in 264 cases, and trans – CBD approach in 221 patients. Procedure was comleted with cystic dump clipping in 138 (28,5%) patients, with external bile duct drainage in 324 (66,8%), and by means of intracorporal bile duct suture in 23 (4,7%) cases. The success rate of CBD stones removal by usage of double stage treatment was 92,6%, and complications occured in 46 (3,1%) patients. Laparoscopic CBD exploration resulted in ductal clearance in 94,5%, complications occured in 28 (5,8%), converted in 12 cases. There were no mortality. Thus laparoscopic CBD exploration and double stage treatment of choledocholithiasis are both acceptable in patients undergoing laparoscopic cholecystectomy.

Session: Poster Presentation

Program Number: P348

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