Laparoscopic management of large common bile duct stones via choledochotomy

Abstract

Introduction Choledocholithiasis is a common complication of cholecystolithiasis. Treatment is advisable to prevent further complications. The optimal treatment for common bile duct (CBD) stones is still unclear, but with advances in laparoscopic instrumentation and acquisition of advanced laparoscopic skills, laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis is increasing in popularity among surgeons worldwide. LCBDE can be performed transcystic or by direct choledochotomy. Laparoscopic transcholedochal CBD exploration is preferable since it provides complete access to the ductal system. The aim The aim of this clinical study is to assess the feasibility, advantages, and complication of laparoscopic management of large CBD stones via choledochotomy. Patients and methods This study included 20 cases with large CBD stones of 10 mm or more. LCBDE transcholedochotomy was done in all cases. Results Twelve cases were closed over T-tube, six cases were closed primarily, and bilioenteric anastomosis was done in one case. The mean operative time was122.5±28.2 min and the mean postoperative hospital stay was 6.30±3.7. Conversion occurred in one case. Conclusion LCBDE transcholedochotomy is a feasible, safe, and cost-effective procedure in patients with large CBD stones.