We have located links that may give you full text access.
Clinical Trial
Journal Article
Management of common bile duct stones in a single operation combining laparoscopic cholecystectomy and peroperative endoscopic sphincterotomy.
The diagnosis and treatment strategy to apply to common bile duct stones (CBDS) is always a controversial subject. The aim of this study was to evaluate the treatment of CBDS in a "one-stage" operation by laparoscopic cholecystectomy (LC) and peroperative endoscopic sphincterotomy (ES). Between January 1994 and April 2000, 60 patients, 24 men and 36 women (sex ratio, 1.5), with a median age of 57 years (range, 26 to 84 years), were treated for suspected or confirmed CBDS. The CBDS were uncomplicated in 53 patients (88%) and associated with a complication in 7 patients (12%); namely, cholangitis (in 3 patients) and acute pancreatitis (in 4 patients). The peroperative ES was performed immediately after the LC during the same operative time, with peroperative cholangiography being systematically performed. The mean operative time for LC was 60 min (range, 40-90 min). The general anesthesia was prolonged by 40 min in order to perform an ES (range, 30-60 min), including the time required for endoscopic equipment installation. The peroperative ES was unsuccessful in 2 patients (3%) due to the impossibility of catheterizing the papilla. In the first patient, postoperative ES was successful. In the second patient, the small CBDS was left to pass spontaneously. In 1 patient, because of multiple calculi in the CBD, open surgery was performed immediately after the ES. In 2 patients, a residual stone was found by cholangiography on the sixth postoperative day, and spontaneous evacuation occurred 2 weeks later. Final ductal clearance was achieved in 100% of the patients. There was no mortality and the incidence of postoperative minor complications was 3% (2 patients). The duration of postoperative hospitalization was 4.6 days (range, 3-11 days). The one-stage treatment procedure is, to us, an alternative to the minimally invasive treatment of CBDS. This method is rapid, reliable, and safe. It now needs to be evaluated in larger studies, keeping in mind that the limiting characteristic is the proximity and the availability of the endoscopic team.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app