10 years of laparoscopic common bile duct exploration: A single tertiary institution experience

Jessica Ballou, Yuxuan Wang, Martin Schreiber, Laszlo Kiraly

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Introduction: Laparoscopic common bile duct exploration (LCBDE-LC) or ERCP plus laparoscopic cholecystectomy (ERCP-LC) represent minimally invasive choledocholithiasis treatments. We hypothesized that LCBDE-LC has a shorter length of stay (LOS) and lower charges than ERCP-LC. Methods: Charts were reviewed for all LCBDE-LC or ERCP-LC for choledocholithiasis from 2007 to 2017. Exclusions included cholangitis, concomitant procedures, or history of Roux-en-Y or biliary surgery. Groups were determined via intention-to-treat with LCBDE-LC or ERCP-LC. Results: 281 subjects were identified; 157 met inclusion criteria. 89 (56%) were in the LCBDE-LC group. There were no differences in age, sex, or ASA. LOS was shorter for LCBDE-LC (3.1 vs 4.4 days, p < 0.01) although total anesthesia time was longer (292 vs 262 min, p = 0.01). There was no difference in total charges ($44,412 vs $51,353, p = 0.08). Thirty (33%) LCBDE-LC were aborted due to challenges passing the dilator or scope (33%) or clearing stones (30%). Two ERCP-LC cases required post-procedure LCBDE. Conclusion: LCBDE-LC resulted in shorter LOS but had a high failure rate. Further research is needed to predict which cases suit each modality.

Original languageEnglish (US)
Pages (from-to)970-973
Number of pages4
JournalAmerican journal of surgery
Volume217
Issue number5
DOIs
StatePublished - May 2019

Keywords

  • Choledocholithiasis
  • Common bile duct exploration
  • Endoscopic retrograde cholangiopancreatography
  • Laparoscopic cholecystectomy

ASJC Scopus subject areas

  • Surgery

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