Abstract
Background Laparoscopic common bile duct exploration has all the advantages of minimal access and is also the most cost effective compared to the other options. Objective To study a profile on laparoscopic common bile duct exploration for a single common duct stone. Methods A total of 30 consecutive patients with solitary common bile duct stone attending our hospital over a period of one year were enrolled in the study. Laparoscopic common bile duct exploration was done by transductal route in all the patients. Results There were 18 females and 12 males with age ranging from 28 to 75 years. Jaundice was present in 12 (40%) patients. Twenty-four (80%) patients had raised alkaline phosphatase. The mean size of CBD on ultrasound was 11.55 mm. The mean size of calculus was 11.06 mm and was located in the distal CBD in 26 (86.7%) patients. The mean operative time was 158.4 ± 57.89 min. There were 8 (26.6%) conversions to open procedure. T-tube was used in 26 (86.7%) patients. The postoperative complications were hospital acquired chest infection in 3 (10%), surgical site infection in 3 (10%), acute coronary syndrome in one (3.3%), and bile leak after T-tube removal in one (3.3%) patient. Conclusions Laparoscopic common bile duct exploration is an effective, safe management of common bile duct stone.
Highlights
10% of patients who undergo laparoscopic cholecystectomy harbor common bile duct stones [1, 2]
Surgeons relied on methods like ERCP ± sphincterotomy with morbidity (15%) and mortality (1%), which increased the hospital stay and cost with additional risk of acute pancreatitis [5]
Common bile duct stones are commonly managed by ERCP ± sphincterotomy, followed by laparoscopic cholecystectomy
Summary
10% of patients who undergo laparoscopic cholecystectomy harbor common bile duct stones [1, 2]. Surgeons relied on methods like ERCP ± sphincterotomy with morbidity (15%) and mortality (1%), which increased the hospital stay and cost with additional risk of acute pancreatitis [5]. This has led to resurgence of LCBDE in common duct stones [5]. A total of 30 consecutive patients with solitary common bile duct stone attending our hospital over a period of one year were enrolled in the study. Laparoscopic common bile duct exploration was done by transductal route in all the patients. Laparoscopic common bile duct exploration is an effective, safe management of common bile duct stone
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