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Journal of Gastrointestinal Surgery

, Volume 18, Issue 4, pp 737–743 | Cite as

Single-Incision Laparoscopic Common Bile Duct Exploration with Conventional Instruments: an Innovative Technique and a Comparative Study

  • Shu-Hung Chuang
  • Pai-Hsi Chen
  • Chih-Ming Chang
  • Yung-Fa TsaiEmail author
  • Chih-Sheng LinEmail author
Original Article

Abstract

Background

Single-incision laparoscopic surgery developed rapidly in recent years. We introduce an innovative technique: single-incision laparoscopic common bile duct exploration (SILCBDE) with conventional instruments. A retrospective comparison between SILCBDE and standard laparoscopic common bile duct exploration (LCBDE) was analyzed.

Methods

Thirty-four patients who underwent LCBDE for choledocholithiasis in a period of 17 months were enrolled. Seventeen standard LCBDEs and 17 SILCBDEs were attempted. Simultaneous cholecystectomies were performed.

Results

The stone clearance rate was 94.1 % (16 patients) in the standard LCBDE group and 100 % in the SILCBDE group. There was no statistical difference in demographic distribution, clinical presentations, and operative results between the two groups, except the SILCBDE group had a higher rate of acute cholecystitis than the standard LCBDE group (76.5 vs. 35.3 %; p < 0.05). One procedure (5.9 %) in the SILCBDE group was converted to a four-incision transcystic LCBDE. The complication rate was 11.8 % (two patients) in the standard LCBDE group and 5.9 % (one patient) in the SILCBDE group. The average follow-up period was 4.2 months.

Conclusion

SILCBDE is as safe and efficacious as standard LCBDE in experienced hands. Choledochoscope manipulation and bile duct repair are the key skills. Long-term follow-up and further prospective randomized trials are anticipated.

Keywords

Choledocholithiasis Choledochotomy Common bile duct exploration Laparoendoscopic single-site surgery Single-incision laparoscopic surgery Transcystic 

Notes

Acknowledgments

We gratefully acknowledge the obligatory works of Ms. Yi-Chun Liao, Ms. Chia-Lin Wu, Ms. Jyun-Ya Li, and Ms. Pei-Yi Wang in assisting with the data collection.

Supplementary material

ESM 1

(WMV 79474 kb)

ESM 2

(WMV 70193 kb)

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Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  1. 1.Department of Biological Science and TechnologyNational Chiao Tung UniversityHsin-ChuTaiwan
  2. 2.Department of SurgeryMackay Memorial HospitalHsin-ChuTaiwan
  3. 3.College of ManagementFu Jen Catholic UniversityNew Taipei CityTaiwan
  4. 4.Department of NursingMackay Memorial HospitalHsin-ChuTaiwan

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