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Diagnostic performance of laparoscopic transcystic common bile duct exploration for the detection of choledocholithiasis in patients with negative MRCP

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Abstract

There is little research to evaluate laparoscopic transcystic common bile duct (CBD) exploration (LTCBDE) as a diagnostic test to identify choledocholithiasis undergoing laparoscopic cholecystectomy (LC). This study aimed to assess the technical success and safety of LTCBDE in patients with suspected choledocholithiasis but negative magnetic resonance cholangiopancreatography (MRCP) undergoing LC. We did an ambispective cohort study in patients with gallstones and suspected CBD stones but negative MRCP undergoing LC. The primary outcomes were the rate of complications in the hospital. Between January 2010 and December 2018, 620 patients (median age, 58 years; 58.4% female) were eligible for the study. The success rate of LTCBDE was 91.8% and CBD stones were observed in 53.3% with a stone clearance rate of 99.3%. The overall postoperative complication rate was 0.65% and no death was recorded in the total cohort. Notably, the morbidity in LTCBDE is 0.53%. Retained CBD stones were diagnosed in 2 patients and managed by ERCP successfully. In the LTCBDE cohort, the median duration of operation was 78 (60–100) min and the median postoperative hospital stay was 1 (1–2) days. Overall, at a mean follow-up of 4.1 (2.3–6.1) years, recurrent CBD stones occurred in 1.1% and all-cause mortality in 0.6%. LTCBDE should be considered the favored choice in the diagnostic algorithm for patients with suspected choledocholithiasis but negative MRCP undergoing LC.

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The authors declare that no patient data appear in this article.

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Funding

This study is sponsored by the Clinical technology innovation projects of the Beijing hospitals authority (No. XMLX202102) and the Beijing Municipal Administration of Hospitals Incubator Program (No. PX2019004).

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Authors and Affiliations

  1. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong’an Road, Xi-Cheng District, Beijing, 100050, China

    Jiegao Zhu, Hongwei Wu, Kun Liu, Dong Wang, Wei Guo & Zhongtao Zhang

  2. National Clinical Research Center for Digestive Diseases, Beijing, China

    Jiegao Zhu, Hongwei Wu, Kun Liu, Dong Wang, Wei Guo & Zhongtao Zhang

Authors
  1. Jiegao Zhu
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  2. Hongwei Wu
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  3. Kun Liu
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  4. Dong Wang
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  5. Wei Guo
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  6. Zhongtao Zhang
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Contributions

WG and ZZ made the study design. JZ, WG, and HW made the data collection. JZ and KL made data analysis. ZZ and WG made data interpretations. JZ, DW, and HW wrote the paper. JZ and WG revised the total manuscript.

Corresponding authors

Correspondence to Jiegao Zhu or Wei Guo.

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Conflict of interest

Drs. Jiegao Zhu, Hongwei Wu, Kun Liu, Dong Wang, Wei Guo, and Zhongtao Zhang have no conflicts of interest to disclose.

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The authors declare that no experiments were performed on humans or animals for this study.

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Zhu, J., Wu, H., Liu, K. et al. Diagnostic performance of laparoscopic transcystic common bile duct exploration for the detection of choledocholithiasis in patients with negative MRCP. Updates Surg 75, 1887–1891 (2023). https://doi.org/10.1007/s13304-023-01524-5

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  • DOI: https://doi.org/10.1007/s13304-023-01524-5

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