Abstract
BackgroundLaparoscopic common bile duct exploration (LCBDE) is a treatment modality for choledocholithiasis. The advantages of this technique are that it is less invasive than conventional open surgery and it permits single-stage management; however, other technical difficulties limit its use. The aim of this article is to introduce our novel technique for LCBDE, which may overcome some of the limitations of conventional LCBDE.Since December 2013, ten patients have undergone LCBDE using a V-shaped choledochotomy (V-CBD). After the confluence of the cystic duct and the CBD were exposed, a V-shaped incision was made along the medial wall of the cystic duct and the lateral wall of the common hepatic duct, which comprise two sides of Calot’s triangle. The choledochoscope was inserted into the lumen of the CBD through a V-shaped incision, and all CBD stones were retrieved using a basket or a Fogarty balloon catheter or were irrigated with saline. After CBD clearance was confirmed using the choledochoscope, the choledochotomy was closed with the bard absorbable suture material known as V-loc.ResultsThe diameter of the CBD ranged from 8 to 30 mm, and the mean size of the stones was 11.6 ± 8.4 mm. The mean operative time was 97.8 ± 30.3 min, and the mean length of the postoperative hospital stay was 6.0 ± 4.6 days. All patients recovered without any postoperative complications, except for one patient who developed postoperative pancreatitis. No conversions to laparotomy were observed, and there were no recurrent stones and no need of T-tube insertion.ConclusionsThis report suggests that our novel technique, known as V-CBD, may represent a feasible and straightforward procedure for treating choledocholithiasis, especially when the CBD is not dilated.
Highlights
Laparoscopic common bile duct exploration (LCBDE) is a treatment modality for choledocholithiasis
CBD exploration through a V-shaped choledochotomy (V-CBD).’. This novel approach may help to overcome the limitations of conventional LCBDE for the surgical treatment of choledocholithiasis
In patients with concomitant cholelithiasis and choledocholithiasis, the treatment paradigm at our center is to initially perform endoscopic retrograde cholangiopancreatography (ERCP) to treat the choledocholithiasis, which is followed by laparoscopic cholecystectomy (LC)
Summary
Laparoscopic common bile duct exploration (LCBDE) is a treatment modality for choledocholithiasis The advantages of this technique are that it is less invasive than conventional open surgery and it permits single-stage management; other technical difficulties limit its use. Surgical common bile duct (CBD) exploration is one of the treatment modalities for choledocholithiasis, which is the second most common complication of cholelithiasis, occurring in approximately 10–15 % of cholelithiasis patients [1, 2]. CBD exploration through a V-shaped choledochotomy (V-CBD).’ This novel approach may help to overcome the limitations of conventional LCBDE for the surgical treatment of choledocholithiasis This approach has advantages over endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST), which is a widely used treatment for choledocholithiasis but carries a significant risk of complications such as acute pancreatitis, duodenal perforation, bleeding, and, importantly, iatrogenic injury to the muscles of the sphincter of Oddi [3, 4].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
