Choledochoscopic lithotripsy is a useful adjunct to laparoscopic common bile duct exploration for hepatolithiasis: a cohort study.

Abstract

BACKGROUND:

This study aims to investigate the role of combining choledochoscopic lithotripsy with laparoscopic common bile duct exploration for hepatolithiasis in patients who are not suitable for hepatectomy.

METHODS:

From March 2009 to March 2013, 86 patients with hepatolithiasis irrespective of whether they underwent a choledochoscopic plasma shock wave lithotripsy or not were analyzed.

RESULTS:

Sixty-two patients underwent lithotripsy and 24 patients underwent basket lithoextraction intraoperatively. Plasma shock wave lithotripsy did not lengthen the operating time, but decreased the postoperative residual stone rate and reduced the frequency of postoperative choledochoscopic lithotomy for patients with remnant stones. The overall final stone clearance rate was 98.8%. During a mean follow-up of 26.2 months, recurrent stones and cholangiocarcinoma developed in 1 patient, respectively.

CONCLUSION:

Laparoscopic common bile duct exploration combined with choledochoscopic lithotripsy is a definitive procedure for hepatolithiasis in patients who are not candidates for hepatectomy.

• Authors: Qingfan Pu, Chuanrong Zhang, Ruifang Ren, Zhenfeng Huang, Kai Jin, Gaojian Cao, Minghui Zhu, Yu Zeng, Weijiang Zhao
• Journal: American journal of surgery (Am J Surg) Vol. 211 Issue 6 Pg. 1058-63 (Jun 2016) ISSN: 1879-1883 [Electronic] United States
• PMID: 27184197 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• China
• Choledocholithiasis (diagnosis, surgery)
• Cohort Studies
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Humans
• Laparoscopy (adverse effects, methods)
• Laparotomy (adverse effects, methods)
• Lithotripsy (adverse effects, methods)
• Male
• Middle Aged
• Patient Selection
• Postoperative Complications (epidemiology, physiopathology)
• Recurrence
• Reoperation
• Retrospective Studies
• Risk Assessment
• Severity of Illness Index
• Treatment Outcome