Laparoscopic Common Bile Duct Exploration Versus Open Approach in Cirrhotic Patients with Choledocholithiasis: A Retrospective Study
To evaluate the safety and benefits of laparoscopic common bile duct exploration (LCBDE) compared with open approach (OCBDE) in cirrhotic patients. Between January 2009 and December 2012, a total of 113 cirrhotic patients with choledocholithiasis underwent common bile duct (CBD) explorations in our...
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| Veröffentlicht in: | Journal of laparoendoscopic & advanced surgical techniques. Part A 2016-12, Vol.26 (12), p.972-977 |
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| container_title | Journal of laparoendoscopic & advanced surgical techniques. Part A |
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| creator | Gui, Liang Liu, Ye Qin, Jun Zheng, Lei Huang, Yi-Jun He, Yue Deng, Wen-Sheng Qian, Bin-Bin Luo, Meng |
| description | To evaluate the safety and benefits of laparoscopic common bile duct exploration (LCBDE) compared with open approach (OCBDE) in cirrhotic patients.
Between January 2009 and December 2012, a total of 113 cirrhotic patients with choledocholithiasis underwent common bile duct (CBD) explorations in our department. There were two groups of patients: A:LCBDE (n = 61) and B:OCBDE (n = 52). Patients' demographic characteristics, surgical data, postoperative outcomes, and long-term results were retrospectively collected and analyzed.
There were no significant differences between the two groups in the demographic characteristics or preoperative status. The transcystic approach was successfully performed in 52 (46.0%) patients (group A:34, group B:20), whereas choledochotomy was successful in 59 (54.0%) patients (group A:27, group B:32). The differences between group A and group B in terms of surgical time (124.9 ± 34.2 minutes versus 132.6 ± 48.6 minutes, P = .323), stone clearance rate (93.4% versus 94.2%, P > .05), short-term complication rate (9.8% versus 13.4%, P = .547), and recurrent stone rate (6.6% versus 5.8%, P > .05) were not statistically significant. However, group A suffered less blood loss [95 (60-200) mL versus 200 (90-450) mL, P |
| doi_str_mv | 10.1089/lap.2016.0308 |
| format | Article |
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Between January 2009 and December 2012, a total of 113 cirrhotic patients with choledocholithiasis underwent common bile duct (CBD) explorations in our department. There were two groups of patients: A:LCBDE (n = 61) and B:OCBDE (n = 52). Patients' demographic characteristics, surgical data, postoperative outcomes, and long-term results were retrospectively collected and analyzed.
There were no significant differences between the two groups in the demographic characteristics or preoperative status. The transcystic approach was successfully performed in 52 (46.0%) patients (group A:34, group B:20), whereas choledochotomy was successful in 59 (54.0%) patients (group A:27, group B:32). The differences between group A and group B in terms of surgical time (124.9 ± 34.2 minutes versus 132.6 ± 48.6 minutes, P = .323), stone clearance rate (93.4% versus 94.2%, P > .05), short-term complication rate (9.8% versus 13.4%, P = .547), and recurrent stone rate (6.6% versus 5.8%, P > .05) were not statistically significant. However, group A suffered less blood loss [95 (60-200) mL versus 200 (90-450) mL, P < .001] and shorter length of hospital stay (4.7 ± 2.5 days versus 11.3 ± 3.1 days, P < .001) than group B. In the LCBDE group, 4 (6.6%) patients were converted due to heavy inflammation and severe adhesions. No mortality, biliary injury, or stricture occurred during follow-up.
LCBDE can be safely performed in patients with Child-Pugh A or B cirrhosis and choledocholithiasis, with considerable efficiency, minimal short-term complications, and acceptable long-term outcomes. LCBDE has the advantages over open CBD exploration of less bleeding and reduced length of hospital stay.</description><identifier>ISSN: 1092-6429</identifier><identifier>EISSN: 1557-9034</identifier><identifier>DOI: 10.1089/lap.2016.0308</identifier><identifier>PMID: 27509535</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Biliary Tract Surgical Procedures - methods ; Blood Loss, Surgical - statistics & numerical data ; Choledocholithiasis - complications ; Choledocholithiasis - surgery ; Common Bile Duct - surgery ; Conversion to Open Surgery - statistics & numerical data ; Female ; Humans ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Liver Cirrhosis - complications ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Journal of laparoendoscopic & advanced surgical techniques. Part A, 2016-12, Vol.26 (12), p.972-977</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c293t-4c5412251db90afcdeba6a64eb13a2a741210e2b09be36ff3173417ce95af0343</citedby><cites>FETCH-LOGICAL-c293t-4c5412251db90afcdeba6a64eb13a2a741210e2b09be36ff3173417ce95af0343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27509535$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gui, Liang</creatorcontrib><creatorcontrib>Liu, Ye</creatorcontrib><creatorcontrib>Qin, Jun</creatorcontrib><creatorcontrib>Zheng, Lei</creatorcontrib><creatorcontrib>Huang, Yi-Jun</creatorcontrib><creatorcontrib>He, Yue</creatorcontrib><creatorcontrib>Deng, Wen-Sheng</creatorcontrib><creatorcontrib>Qian, Bin-Bin</creatorcontrib><creatorcontrib>Luo, Meng</creatorcontrib><title>Laparoscopic Common Bile Duct Exploration Versus Open Approach in Cirrhotic Patients with Choledocholithiasis: A Retrospective Study</title><title>Journal of laparoendoscopic & advanced surgical techniques. Part A</title><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><description>To evaluate the safety and benefits of laparoscopic common bile duct exploration (LCBDE) compared with open approach (OCBDE) in cirrhotic patients.
Between January 2009 and December 2012, a total of 113 cirrhotic patients with choledocholithiasis underwent common bile duct (CBD) explorations in our department. There were two groups of patients: A:LCBDE (n = 61) and B:OCBDE (n = 52). Patients' demographic characteristics, surgical data, postoperative outcomes, and long-term results were retrospectively collected and analyzed.
There were no significant differences between the two groups in the demographic characteristics or preoperative status. The transcystic approach was successfully performed in 52 (46.0%) patients (group A:34, group B:20), whereas choledochotomy was successful in 59 (54.0%) patients (group A:27, group B:32). The differences between group A and group B in terms of surgical time (124.9 ± 34.2 minutes versus 132.6 ± 48.6 minutes, P = .323), stone clearance rate (93.4% versus 94.2%, P > .05), short-term complication rate (9.8% versus 13.4%, P = .547), and recurrent stone rate (6.6% versus 5.8%, P > .05) were not statistically significant. However, group A suffered less blood loss [95 (60-200) mL versus 200 (90-450) mL, P < .001] and shorter length of hospital stay (4.7 ± 2.5 days versus 11.3 ± 3.1 days, P < .001) than group B. In the LCBDE group, 4 (6.6%) patients were converted due to heavy inflammation and severe adhesions. No mortality, biliary injury, or stricture occurred during follow-up.
LCBDE can be safely performed in patients with Child-Pugh A or B cirrhosis and choledocholithiasis, with considerable efficiency, minimal short-term complications, and acceptable long-term outcomes. LCBDE has the advantages over open CBD exploration of less bleeding and reduced length of hospital stay.</description><subject>Adult</subject><subject>Aged</subject><subject>Biliary Tract Surgical Procedures - methods</subject><subject>Blood Loss, Surgical - statistics & numerical data</subject><subject>Choledocholithiasis - complications</subject><subject>Choledocholithiasis - surgery</subject><subject>Common Bile Duct - surgery</subject><subject>Conversion to Open Surgery - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Liver Cirrhosis - complications</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>1092-6429</issn><issn>1557-9034</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEtP3DAQgK0KVJZtj71WPnLJ4lce5rZNeUkrgaDtNXKciWKUxK7tQLnzw-sVD1_GnvlmPPoQ-kbJhpJKno7KbRihxYZwUn1CK5rnZSYJFwfpTiTLCsHkEToO4YGkI7n4jI5YmROZ83yFXnbKKW-Dts5oXNtpsjP-YUbAPxcd8fk_N1qvoknZP-DDEvCNgxlvnfNW6QGbGdfG-8HG1H6bQJhjwE8mDrge7Aid1Smkp1HBhDO8xXcQ038OdDSPgO_j0j1_QYe9GgN8fYtr9Pvi_Fd9le1uLq_r7S7TTPKYCZ0LylhOu1YS1esOWlWoQkBLuWKqTEVKgLVEtsCLvue05IKWGmSu-mSEr9HJ69y0_N8FQmwmEzSMo5rBLqGhlSirUlJRJTR7RXVaNnjoG-fNpPxzQ0mzF98k8c1efLMXn_jvb6OXdoLug343zf8DTeKA5w</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Gui, Liang</creator><creator>Liu, Ye</creator><creator>Qin, Jun</creator><creator>Zheng, Lei</creator><creator>Huang, Yi-Jun</creator><creator>He, Yue</creator><creator>Deng, Wen-Sheng</creator><creator>Qian, Bin-Bin</creator><creator>Luo, Meng</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201612</creationdate><title>Laparoscopic Common Bile Duct Exploration Versus Open Approach in Cirrhotic Patients with Choledocholithiasis: A Retrospective Study</title><author>Gui, Liang ; Liu, Ye ; Qin, Jun ; Zheng, Lei ; Huang, Yi-Jun ; He, Yue ; Deng, Wen-Sheng ; Qian, Bin-Bin ; Luo, Meng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-4c5412251db90afcdeba6a64eb13a2a741210e2b09be36ff3173417ce95af0343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biliary Tract Surgical Procedures - methods</topic><topic>Blood Loss, Surgical - statistics & numerical data</topic><topic>Choledocholithiasis - complications</topic><topic>Choledocholithiasis - surgery</topic><topic>Common Bile Duct - surgery</topic><topic>Conversion to Open Surgery - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Liver Cirrhosis - complications</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gui, Liang</creatorcontrib><creatorcontrib>Liu, Ye</creatorcontrib><creatorcontrib>Qin, Jun</creatorcontrib><creatorcontrib>Zheng, Lei</creatorcontrib><creatorcontrib>Huang, Yi-Jun</creatorcontrib><creatorcontrib>He, Yue</creatorcontrib><creatorcontrib>Deng, Wen-Sheng</creatorcontrib><creatorcontrib>Qian, Bin-Bin</creatorcontrib><creatorcontrib>Luo, Meng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gui, Liang</au><au>Liu, Ye</au><au>Qin, Jun</au><au>Zheng, Lei</au><au>Huang, Yi-Jun</au><au>He, Yue</au><au>Deng, Wen-Sheng</au><au>Qian, Bin-Bin</au><au>Luo, Meng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic Common Bile Duct Exploration Versus Open Approach in Cirrhotic Patients with Choledocholithiasis: A Retrospective Study</atitle><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><date>2016-12</date><risdate>2016</risdate><volume>26</volume><issue>12</issue><spage>972</spage><epage>977</epage><pages>972-977</pages><issn>1092-6429</issn><eissn>1557-9034</eissn><abstract>To evaluate the safety and benefits of laparoscopic common bile duct exploration (LCBDE) compared with open approach (OCBDE) in cirrhotic patients.
Between January 2009 and December 2012, a total of 113 cirrhotic patients with choledocholithiasis underwent common bile duct (CBD) explorations in our department. There were two groups of patients: A:LCBDE (n = 61) and B:OCBDE (n = 52). Patients' demographic characteristics, surgical data, postoperative outcomes, and long-term results were retrospectively collected and analyzed.
There were no significant differences between the two groups in the demographic characteristics or preoperative status. The transcystic approach was successfully performed in 52 (46.0%) patients (group A:34, group B:20), whereas choledochotomy was successful in 59 (54.0%) patients (group A:27, group B:32). The differences between group A and group B in terms of surgical time (124.9 ± 34.2 minutes versus 132.6 ± 48.6 minutes, P = .323), stone clearance rate (93.4% versus 94.2%, P > .05), short-term complication rate (9.8% versus 13.4%, P = .547), and recurrent stone rate (6.6% versus 5.8%, P > .05) were not statistically significant. However, group A suffered less blood loss [95 (60-200) mL versus 200 (90-450) mL, P < .001] and shorter length of hospital stay (4.7 ± 2.5 days versus 11.3 ± 3.1 days, P < .001) than group B. In the LCBDE group, 4 (6.6%) patients were converted due to heavy inflammation and severe adhesions. No mortality, biliary injury, or stricture occurred during follow-up.
LCBDE can be safely performed in patients with Child-Pugh A or B cirrhosis and choledocholithiasis, with considerable efficiency, minimal short-term complications, and acceptable long-term outcomes. LCBDE has the advantages over open CBD exploration of less bleeding and reduced length of hospital stay.</abstract><cop>United States</cop><pmid>27509535</pmid><doi>10.1089/lap.2016.0308</doi><tpages>6</tpages></addata></record> |
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| ispartof | Journal of laparoendoscopic & advanced surgical techniques. Part A, 2016-12, Vol.26 (12), p.972-977 |
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| subjects | Adult Aged Biliary Tract Surgical Procedures - methods Blood Loss, Surgical - statistics & numerical data Choledocholithiasis - complications Choledocholithiasis - surgery Common Bile Duct - surgery Conversion to Open Surgery - statistics & numerical data Female Humans Laparoscopy - methods Length of Stay - statistics & numerical data Liver Cirrhosis - complications Male Middle Aged Operative Time Retrospective Studies Treatment Outcome |
| title | Laparoscopic Common Bile Duct Exploration Versus Open Approach in Cirrhotic Patients with Choledocholithiasis: A Retrospective Study |
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