How often might a trans–cystic-duct stone extraction be feasible?

Abstract

Background: Although the sizes of the cystic duct and concomitant bile duct stones are fundamental in evaluating the possibility of a trans–cystic-duct approach as an alternative to cholangiotomy, no conclusive data are supplied in the reports on laparoscopic cholecystectomy.

Method: The narrowest inner diameter of the cystic duct and the diameter of the largest concomitant bile duct stone are compared in a prospective study of 30 consecutive patients.

Results: The bile duct stones were smaller than the cystic duct in 14 patients, 47%, and of equal size in nine, 30%. They were larger than the cystic duct in the remaining seven patients, 23%, with a difference of only 1 mm in five patients and of 2 and 4 mm, respectively, in two.

Conclusions: Physical conditions allowing a trans–cystic-duct stone extraction were present in 23 of 30 patients and an attempt might have been possible after, for example, cystic duct dilatation in a further five.