J Minim Invasive Surg.  2016 Dec;19(4):130-134. 10.7602/jmis.2016.19.4.130.

Laparoscopic Common Bile Duct Exploration : A Feasible Option for Choledocholithiasis in Patients with Previous Gastrectomy

• Choi HR
• Kim JD
• Choi DL

• KMID: 2362228
• DOI: http://doi.org/10.7602/jmis.2016.19.4.130

Abstract

PURPOSE
Previous gastrectomy has been considered to be a relative contraindication for laparoscopic common bile duct exploration (LCBDE) because of concerns regarding severe adhesions in the operative field and technical complexity. This study evaluated the feasibility and safety of LCBDE in patients with previous gastrectomy.
METHODS
We retrospectively reviewed the clinical outcomes of 58 patients who underwent LCBDE in our institution between January 2005 and December 2014: group I comprised patients with no previous abdominal surgery (n=43) and group II comprised patients with previous gastrectomy (n=15). Patient demographics and perioperative variables were compared between groups.
RESULTS
The perioperative variables did not differ significantly between groups. The operating time, open conversion rate, and morbidity rate were similar in groups I and II, despite the more complicated cases in group II. Moreover, the presence of remnant bile duct stones and biliary strictures, and the postoperative hospital stay, did not differ significantly between groups. The mean time to oral intake did not differ between groups, although this diet resumption time was significantly shorter in groups I and II than in a group undergoing open choledocholithomy (p=0.04).
CONCLUSION
Laparoscopic common bile duct exploration is safe and effective in patients with histories of gastrectomy.

Keyword

Laparoscopy; Gastrectomy; Choledocholithiasis; Complication

MeSH Terms

Bile Ducts
Choledocholithiasis*
Common Bile Duct*
Constriction, Pathologic
Demography
Diet
Gastrectomy*
Humans
Laparoscopy
Length of Stay
Retrospective Studies