Treatment of common bile duct stones discovered during cholecystectomy

Edward H. Phillips, James Toouli, Henry A. Pitt, Nathaniel J. Soper

Research output: Contribution to journalArticle

Abstract

Several techniques of laparoscopic bile duct exploration and intraoperative endoscopic sphincterotomy (ES) have been developed to treat patients with common bile duct (CBD) stones in one session and avoid the complications of ES. With all these options available, very few randomized controlled trials (RCTs) have been undertaken. This review analyzes those studies. We searched PubMed. Four RCTs and a Cochran Database Systematic Review were found. Two RCTs compared preoperative ES and laparoscopic CBD exploration (E) for known CBD stones. Laparoscopic CBDE had shorter length of hospitalization. Two RCTs compared immediate and delayed treatment and found that length of stay was less with laparoscopic CBDE, but clearance rates and morbidity/mortality were similar. Studies suggest that CBD stones discovered at the time of cholecystectomy are best treated during the same operation. The transcystic approach is safest if applicable. Individual surgeons must be aware of their own capabilities and those of the available endoscopists and perform the safest technique.

Original languageEnglish (US)
Pages (from-to)624-628
Number of pages5
JournalJournal of Gastrointestinal Surgery
Volume12
Issue number4
DOIs
StatePublished - Apr 2008
Externally publishedYes

Fingerprint

Common Bile Duct
Cholecystectomy
Endoscopic Sphincterotomy
Randomized Controlled Trials
Therapeutics
Bile Ducts
PubMed
Length of Stay
Hospitalization
Databases
Morbidity
Mortality

Keywords

  • Bile duct stones
  • CBD stones
  • Cholecystectomy
  • Choledocholithiasis
  • Common bile duct exploration
  • Laparoscopic choledochotomy

ASJC Scopus subject areas

  • Surgery

Cite this

Treatment of common bile duct stones discovered during cholecystectomy. / Phillips, Edward H.; Toouli, James; Pitt, Henry A.; Soper, Nathaniel J.

In: Journal of Gastrointestinal Surgery, Vol. 12, No. 4, 04.2008, p. 624-628.

Research output: Contribution to journalArticle

Phillips, Edward H. ; Toouli, James ; Pitt, Henry A. ; Soper, Nathaniel J. / Treatment of common bile duct stones discovered during cholecystectomy. In: Journal of Gastrointestinal Surgery. 2008 ; Vol. 12, No. 4. pp. 624-628.
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