Abstract
Background: A combined method of endoscopic sphincterotomy (ES) with common bile duct stone (CBDS) extraction and laparoscopic cholecystectomy (LC) under general anesthesia for a single-session treatment of patients with colecysto-choledocholithiasis is described.
Methods: From June 1994 to January 1995, 15 consecutive cases considered for elective LC with preoperative diagnosis of CBDS underwent this procedure. Following orotracheal intubation, the patient is turned on the left lateral decubitus for ES and CBDS extraction. Nasobiliary drainage is positioned for per-laparoscopic cholangiogram. Routine LC is finally performed.
Results: These two interventions were successfully accomplished in all patients. Mean duration of the operative time for the combined procedure was 97.7±30.4 min, range 60–140 min. In four (26.6%) cases an accessory trocar with retracting instrument was used to obviate the bowel distension.
Conclusions: No complications of ES or LC were observed. Mean hospital stay was 3 days (range 2–5 days). Routine follow-up (mean 3±2 months, range 1–12 months) did not reveal biliary-related problems in any of the observed patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Angrisani L, Lorenzo M, De Palma G, Sivero L, Catazano C, Tesauro B, Persico G (1995) Laparoscopic cholecystectomy in obese patients compared with non obese patients. Surg Laparosc Endosc 5: 197–201
Arregui ME, Davis CJ, Arkush AM, Nagan RF (1992) Laparoscopic cholecystectomy combined with endoscopic sphincterotomy and stone extraction or laparoscopic choledoscopy and electrohydraulic lithotripsy for management of cholelithiasis with choledocholithiasis. Surg Endosc 6: 10–15
Berci G, Morgestern L (1994) Laparoscopic management of common bile duct stones. A multi-institutional SAGES study. Surg Endosc 8: 1168–1175
Binmoeller KF, Soehendra N, Liguory C (1994) The common bile duct stone: time to leave it to laparoscopic surgeon? Endoscopy 26: 315–319
Cotton PB, Chung SC, Davis WZ, Gibson RM, Ransohoff DS, Strasberg SM (1994) Issues in cholecystectomy and management of duct stones. Am J Gastroenterol 89(8): 169–176
DePaula AL, Hashiba K, Bafutto M (1994) Laparoscopic management of choledocholithiasis. Surg Endosc 8: 1399–1403
Deslandres E, Gagner M, Pomp A, Rheault M, Leduc R, Clermont R, Gratton J, Bernard EJ (1993) Intraoperative endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy. Gastrointest Endosc 39: 45–58
Feretis C, Kalliakmanis P, Benakis P, Apostolidis N (1994) Laparoscopic transcystic papillotomy under endoscopic control for bile duct stones. Endoscopy 26: 697–700
Garcia-Caballero M, Martin-Palanca A, Vara-Thorbeck C (1994) Common bile duct stones after laparoscopic cholecystectomy and its treatment. Surg Endosc 8: 1182–1185
Heinmann PA, Boeckl O, Pinyl W (1989) Selective ERCP and preoperative stone removal in bile duct surgery. Ann Surg 209: 267–272
Kozarek RA (1988) Balloon dilation of the sphincter of Oddi. Endoscopy 20: 207–210
McSherry CK (1994) Laparoscopic management of common bile duct stones. Surg Endosc 8: 1161–1162
Neoptolemos JP, Carr-Locke DL, Fossard DP (1987) Prospective randomized study of preoperative endoscopic sphincterotomy versus surgery alone for common bile duct stones. BMJ 249: 470–474
Phillips EH, Rosenthal RJ, Carrol BJ, Fallas MJ (1994) Laparoscopic trans-cystic common bile duct exploration. Surg Endosc 8: 1389–1394
Phillips EH, Carrol BJ, Fallas MM (1992) Common duct stones: removal before or during laparoscopic cholecystectomy? Surg Endosc 6: 266–268
Ponchon T, Bory R, Chavaillon A, Fouillet P (1989) Biliary lithiasis: combined endoscopic and surgical treatment. Endoscopy 21: 15–18
Siddiqui MN, Hamid S, Khan H, Ahmed M (1994) Per-operative endoscopic retrograde cholangiopancreatography for common bile duct stones. Gastrointest Endosc 40(3): 348–350
Sherman S, Gottlieb K, Lehman GA (1994) Therapeutic biliary endoscopy. Endoscopy 26: 93–112
Slivka A, Carr-Locke DL (1992) Therapeutic biliary endoscopy. Endoscopy 24: 100–119
Van Stiegman G, Pearlman NW, Goff JJ, Mansour A (1989) Endoscopic cholangiography and stone removal prior to cholecystectomy. Ann Surg 124: 787–790
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
De Palma, G.D., Angrisani, L., Lorenzo, M. et al. Laparoscopic cholecystectomy (LC), intraoperative endoscopic sphincterotomy (ES), and common bile duct stones (CBDS) extraction for management of patients with cholecystocholedocholithiasis. Surg Endosc 10, 649–652 (1996). https://doi.org/10.1007/BF00188520
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00188520