Intraoperative endoscopic retrograde cholangio-pancreatography: a useful tool in the hands of the hepatobiliary surgeon.

Abstract

AIM:

To evaluate the efficacy of intraoperative endoscopic retrograde cholangio-pancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) for patients with gall bladder stones (GS) and common bile duct stones (CBDS).

METHODS:

Patients treated for GS with CBDS were included. LC and intraoperative transcystic cholangiogram (TCC) were performed in most of the cases. Intraoperative ERCP was done for cases with proven CBDS.

RESULTS:

Eighty patients who had GS with CBDS were included. LC was successful in all cases. Intraoperative TCC revealed passed CBD stones in 4 cases so intraoperative ERCP was performed only in 76 patients. Intraoperative ERCP showed dilated CBD with stones in 64 cases (84.2%) where removal of stones were successful; passed stones in 6 cases (7.9%); short lower end stricture with small stones present in two cases (2.6%) which were treated by removal of stones with stent insertion; long stricture lower 1/3 CBD in one case (1.3%) which was treated by open hepaticojejunostomy; and one case (1.3%) was proved to be ampullary carcinoma and whipple's operation was scheduled.

CONCLUSION:

The hepatobiliary surgeon should be trained on ERCP as the third hand to expand his field of therapeutic options.

• Authors: Ayman El Nakeeb, Ahmad M Sultan, Emad Hamdy, Ehab El Hanafy, Ehab Atef, Tarek Salah, Ahmed A El Geidie, Tharwat Kandil, Mohamed El Shobari, Gamal El Ebidy
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 21 Issue 2 Pg. 609-15 (Jan 14 2015) ISSN: 2219-2840 [Electronic] United States
• PMID: 25605984 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adolescent
• Adult
• Cholangiopancreatography, Endoscopic Retrograde (adverse effects)
• Cholecystectomy, Laparoscopic (adverse effects)
• Cholecystolithiasis (diagnosis, surgery)
• Choledocholithiasis (diagnosis, surgery)
• Female
• Gallstones (diagnosis, surgery)
• Humans
• Intraoperative Care
• Male
• Middle Aged
• Treatment Outcome
• Young Adult