RT Journal Article
T1 Multi-institutional expert update on the use of laparoscopic bile duct exploration in the management of choledocholithiasis: Lesson learned from 3950 procedures.
A1 Lopez-Lopez, Víctor
A1 Gil-Vazquez, Pedro José
A1 Ferreras, David
A1 Nassar, Ahmad H M
A1 Bansal, Virinder K
A1 Topal, Baki
A1 Zhu, Jie-Gao
A1 Chuang, Shu-Hung
A1 Jorba, Rosa
A1 Bekheit, Mohamed
A1 Martinez-Cecilia, David
A1 Parra-Membrives, Pablo
A1 Sgourakis, Georgios
A1 Mattila, Anne
A1 Bove, Aldo
A1 Quaresima, Silvia
A1 Barreras González, Javier Ernesto
A1 Sharma, Anil
A1 Ruiz, Juan Jose
A1 Sánchez-Bueno, Francisco
A1 Robles-Campos, Ricardo
A1 Martinez-Isla, Alberto
K1 bile duct exploration
K1 biliary tract
K1 cystic duct
K1 laparoscopy
K1 lithiasis
AB Recently there has been a growing interest in the laparoscopic management of common bile duct stones with gallbladder in situ (LBDE), which is favoring the expansion of this technique. Our study identified the standardization factors of LBDE and its implementation in the single-stage management of choledocholithiasis. A retrospective multi-institutional study among 17 centers with proven experience in LBDE was performed. A cross-sectional survey consisting of a semi-structured pretested questionnaire was distributed covering the main aspects on the use of LBDE in the management of choledocholithiasis. A total of 3950 LBDEs were analyzed. The most frequent indication was jaundice (58.8%). LBDEs were performed after failed ERCP in 15.2%. The most common approach used was the transcystic (63.11%). The overall series failure rate of LBDE was 4% and the median rate for each center was 6% (IQR, 4.5-12.5). Median operative time ranged between 60-120 min (70.6%). Overall morbidity rate was 14.6%, with a postoperative bile leak and complications ≥3a rate of 4.5% and 2.5%, respectively. The operative time decreased with experience (P = .03) and length of hospital stay was longer in the presence of a biliary leak (P = .04). Current training of LBDE was defined as poor or very poor by 82.4%. Based on this multicenter survey, LBDE is a safe and effective approach when performed by experienced teams. The generalization of LBDE will be based on developing training programs.
YR 2022
FD 2022-02-17
LK http://hdl.handle.net/10668/22184
UL http://hdl.handle.net/10668/22184
LA en
DS RISalud
RD Apr 18, 2025