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Laparoscopic Transcystic Common Bile Duct Exploration in the Emergency Is as Effective and Safe as in Elective Setting

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Emergent laparoscopic transcystic common bile duct exploration (LTCBDE) has been reported to be on the increase in some institutions, reflecting the growing confidence with the technique. However, no study has focused on the outcomes of LTCBDE in the non-elective setting. The aim of this study is to investigate whether LTCBDE can be performed effectively and safely in the emergency.

Methods

This is a retrospective study of 500 consecutive patients with choledocholithiasis subjected for LTCBDE at the Hospital Italiano de Buenos Aires from January 2009 to January 2018. Procedures were classified according to the setting as emergent or elective. Demographic data and perioperative parameters were compared between groups.

Results

Throughout the period comprised, 500 patients were admitted for choledocholithiasis and gallstones. A single-step treatment combining LTCBDE and laparoscopic cholecystectomy was attempted: 211 (42.2%) were performed electively and the 289 (57.8%) as an emergency. There was no significant difference in the success rate of LTCBDE (93.9% versus 93.8%, p = 0.975) for the two groups. The operative time was slightly longer in the emergency group (122 ± 63 versus 106 ± 53 min, p = 0.002). Postoperative recovery was slower in the emergency group, as reflected by a higher rate of prolonged postoperative stay (21.1% vs 5.7%, p < .001). The rates of postoperative complications were similar between groups (2.8% vs 5.9%, p = 0.109).

Conclusion

Emergent LTCBDE can be performed with equivalent efficacy and morbidity when compared to an elective procedure. Patients undergoing emergent procedures have longer procedures and hospital stays.

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Authors and Affiliations

  1. Department of General Surgery, Division of HPB Surgery, Hospital Italiano de Buenos Aires, Juan D. Peron 4190, C1181ACH, Buenos Aires, Argentina

    Matias E. Czerwonko, Juan Pekolj, Pedro Uad, Oscar Mazza, Rodrigo Sanchez-Claria, Guillermo Arbues, Eduardo de Santibañes, Martín de Santibañes & Martín Palavecino

Authors
  1. Matias E. Czerwonko
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  2. Juan Pekolj
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  3. Pedro Uad
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  4. Oscar Mazza
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  5. Rodrigo Sanchez-Claria
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  6. Guillermo Arbues
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  7. Eduardo de Santibañes
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  8. Martín de Santibañes
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  9. Martín Palavecino
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Contributions

Study conception and design: Matías Czerwonko, Martín de Santibañes, Guillermo Arbues, Eduardo de Santibañes, Martin Palavecino.

Acquisition of data: Matias Czerwonko, Martin de Santibañes, Pedro Uad, Guillermo Arbues, Oscar Mazza, Rodrigo Sanchez-Claria.

Analysis and interpretation of data: Matias Czerwonko, Martin de Santibañes, Pedro Uad, Eduardo de Santibañes, Juan Pekolj, Martin Palavecino.

Drafting of manuscript: Matias Czerwonko, Martin de Santibañes, Juan Pekolj, Eduardo De Santibañes, Juan Pekolj, Martin Palavecino.

Critical revision: Oscar Mazza, Guillermo Arbues, Rodrigo Sanchez-Claria.

Corresponding author

Correspondence to Martín Palavecino.

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Czerwonko, M.E., Pekolj, J., Uad, P. et al. Laparoscopic Transcystic Common Bile Duct Exploration in the Emergency Is as Effective and Safe as in Elective Setting. J Gastrointest Surg 23, 1848–1855 (2019). https://doi.org/10.1007/s11605-018-4029-x

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  • DOI: https://doi.org/10.1007/s11605-018-4029-x

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