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[Results of laparoscopic treatement of common bile duct lithiasis. Report of 30 cases].

AbstractAIM:
The aim of this retrospective study was to report the results of the laparoscopic management of common bile duct stones in an unicentric series of 30 patients.
METHODS:
From January 2001 to April 2004. 30 patients: 23 women, 7 men (mean age: 54 years). underwent a common bile duct exploration for lithiasis through a laparoscopic approach. The patients were hospitalized for angiocholitis (n = 12), cholecystitis (n= 4), jaundice (n = 4), pancreatitis (n = 3), abnormality of hepatic tests (n = 7). All the patients underwent an intra operative cholangiography. Removal of the stones was tried in 30 cases through a choledochotomy. never through the cystic duct, using Dormia and Fogarty catheters. External biliary drainage with T tube (kehr) and postoperative cholangiography was done systematically.
RESULTS:
In 21 patients (70 %), removal of the stones was laparoscopically successful. The average diameter of the common bile duct was 10.5 mm (range 6-20 mm). The median number of stones was 5 (E: 1-12). The median operation time was 180mn (range 150-300mn). In 9 patients, a conversion into laparotomy was necessary for several reasons. In 2 patients with residual common bile duct, the stones were treated successfully by endoscopic sphincterotomy. There was no mortality and the morbidity rate was 10 %. The mean postoperative hospital stay was 14.7 days (range 7-18days) and 13.3 days in case of successful laparoscopic management.
CONCLUSION:
In 70 % of the patients, the treatment of the common bile-duct lithiasis could be achieved laparoscopically, but conventional approach and endoscopic sphincterotomy are still useful in case of failure of the laparoscopic management.
AuthorsMohamed N Arfa, Sadri Ben Abid, Lasaad Gharbi, Saber Mannai, N Haoues, N Miloudi, M Guilani, Brahim Ghariani, Hafedh Mestiri, M Tahar Khalfallah
JournalLa Tunisie medicale (Tunis Med) Vol. 84 Issue 12 Pg. 786-9 (Dec 2006) ISSN: 0041-4131 [Print] Tunisia
Vernacular TitleResultats du traitement laparoscopique de la lithiase de la voie biliaire principale. Etude de 30 cas.
PMID17288281 (Publication Type: Comparative Study, English Abstract, Journal Article, Review)
Topics
  • Adult
  • Aged
  • Female
  • Gallstones (surgery)
  • Humans
  • Laparoscopy
  • Male
  • Middle Aged
  • Retrospective Studies

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