Abstract | BACKGROUND: Laparoscopic common bile duct exploration is commonplace in adults; however, this procedure is not often performed in children. The goal of this study was to evaluate the results of laparoscopic common bile duct exploration in children. METHODS: Of 50 patients undergoing laparoscopic cholecystectomy, six patients (12%) had obstructing lesions of the common bile duct (CBD). Five children underwent laparoscopic common bile duct exploration, and one child had a preoperative endoscopic sphincterotomy and stone removal. RESULTS: The mean age at laparoscopic CBD exploration was 11.6 years (range, 5-16). The obstructing lesion was visualized by intraoperative cholangiography in all five patients. The mean operative time for laparoscopic cholecystectomy along with CBD exploration was 215 min (range, 160-282). The transcystic laparoscopic CBD exploration was performed using a 7-Fr, multichannel rigid, or 10-Fr flexible fiberoptic cystoscope. The stones were either pushed into the duodenum with the scope or extracted through the cystic duct using a 3-Fr Segura basket. In one patient, a candidial ball disintegrated during an attempt to remove it with the basket. A repeat cholangiogram at the end of each procedure showed an anatomically normal CBD with free flow of contrast into the duodenum. All patients enjoyed a quick recovery. They were started on a regular diet on the same day of surgery and discharged on the 1st or 2nd postoperative day. One patient with sickle cell disease developed a pulmonary infarction and required 5 additional days of hospitalization. One patient developed recurrent choledocholithiasis 6 months after laparoscopic exploration and was treated successfully with endoscopic sphincterotomy and stone extraction. CONCLUSIONS:
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Authors | R S Shah, M L Blakely, T E Lobe |
Journal | Surgical endoscopy
(Surg Endosc)
Vol. 15
Issue 11
Pg. 1353-5
(Nov 2001)
ISSN: 1432-2218 [Electronic] Germany |
PMID | 11727149
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Child
- Child, Preschool
- Cholangiography
- Cholecystectomy
(methods)
- Cholestasis
(surgery)
- Common Bile Duct
(surgery)
- Fiber Optic Technology
- Humans
- Laparoscopy
(methods)
- Monitoring, Intraoperative
- Recurrence
- Treatment Outcome
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