Laparoscopic Common Bile Duct Exploration: Experience of 22 Patients

Abstract

Laparoscopic common bile duct exploration (LCBDE) is gaining favor for the management of common bile duct stones. This study presents our laparoscopic approach in patients with common bile duct stones. Materials and Methods: Between January 2000 and December 2002, 69 patients with CBD stones were reviewed and collected information. Thirty-six patients (52%) of these 69 patients with CBD stones were managed by open exploration. LCBDE was attempted in 22 selected patients (32%) with stable hemodynamic states. The other 11 patients (16%) were managed by robot-assisted LCBDE. LCBDE was carried out with a choledochotomy and T-tube drainage. Results: We divided the 22 patients who had undergone LCBDE into two groups for analysis. In two cases (9%), the LCBDE was converted to open common bile duct exploration. The first 17 patients were assigned to group A, and the last 5 patients to group B. There were no operative mortalities, but 2 cases of complications (9%) in group A, and 1 case of retained stones (4.5%) in group B. One patient with recurrent stones underwent hepaticojejunostomy. Conclusions: LCBDE is not yet accepted as the standard procedure for choledocholithiasis, and we need more cases to fully evaluate the safety and feasibility of LCBDE for further trials and meta-analyses.