Innovative hybrid technique of bile duct exploration in the treatment of Choledocolithiasis

Daniel Navarini,Deise Dessanti,André Luca Boeira Rovani,Henrique Waltrick De Albuquerque,Antônio Benincá Albuquerque,Carlos Augusto Scussel Madalosso,Diego Reffatti

doi:10.22491/2357-9730.97337

Abstract

Common bile stone disease (CBDS) is frequent and has potentially severe complications, such as acute biliary pancreatitis and cholangitis. Unnecessary and unplanned procedures must be avoided, so before choosing the best treatment of common bile duct lithiasis it is essential to have a proper diagnose. CBDS is currently treated by therapeutic endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic bile duct exploration (LCBDE). The aim of this article is to present a innovative hybrid technique of common bile duct exploration, on account of one option in those cases where the laparoscopic approach is not resolutive, avoiding the need of conversion to open approach technique. The hybrid technique has the same benefits of open and laparoscopic techniques, but without increasing costs with material and with good resolutivity in complex cases of common bile duct stones. Keywords: Choledocholithiasis; laparoscopic common bile duct exploration; LCBDE; open common bile duct exploration

Highlights

Common bile stone disease (CBDS) is frequent and has potentially severe complications, such as acute biliary pancreatitis and cholangitis
The primary or autochthone calculi are usually related to chronic bile stasis, due to different factors – biliary stenosis, chronic papillitis, recurrent cholangitis, Oddi’s sphincter dysfunction, or pancreatic cholangiopathy
Patients who have been submitted to cholecystectomy and are diagnosed with common bile duct lithiasis after 2 years of surgery are considered as having primary calculi

Summary

Introduction

Common bile stone disease (CBDS) is frequent and has potentially severe complications, such as acute biliary pancreatitis and cholangitis. Patients who have been submitted to cholecystectomy and are diagnosed with common bile duct lithiasis after 2 years of surgery are considered as having primary calculi. Common bile duct stone may occur in 3%-14% of patients who have already been submitted to cholecystectomy.

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