J Korean Surg Soc.
2000 Mar;58(3):420-425.
Laparoscopic Surgery for Common Bile Duct Stone
- Affiliations
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- 1Department of Surgery, College of Medicine, Ewha Womans University.
Abstract
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PURPOSE: Application of a laparoscopic technique to common bile duct explorations has been limited
due to technical difficulty. With increased experience and technique, laparoscopic surgery has become
a possible option for the treatment of common bile duct stones. The purpose of this study was to assess
the usefulness of laparoscopic surgery in the treatment of common bile duct stones. METHODS: Between
March 1997 and August 1999, 35 patients with choledocholithiasis were treated with laparoscopic
common bile duct exploration (4 had a previous biliary operative history). Intraoperative choledochoscopy
was used to remove common bile duct stones. The stones were retrieved by using a saline flush, a basket,
or a Fogarty catheter. The impacted stones were destroyed using electrohydraulic lithotripsy. RESULTS:
Successful laparoscopic stone clearance was achieved in 33 cases (94.3%), and conversion to open surgery
occurred in one case (2.9%). The morbidity was 5.7% without mortality. Two cases of retained stone
were treated with postoperative choledochoscopic removal via fistula tract and postoperative endoscopic
extraction. CONCLUSION: Laparoscopic common bile duct exploration is feasible and safe in most patients.
With increased of experience, laparoscopic common bile duct exploration could be used widely.