Articles producció científica> Medicina i Cirurgia

Multi-institutional expert update on the use of laparoscopic bile duct exploration in the management of choledocholithiasis: Lesson learned from 3950 procedures

  • Identification data

    Identifier: imarina:9245942
    Authors:
    Lopez-Lopez VGil-Vazquez PJFerreras DNassar AHMBansal VKTopal BZhu JGChuang SHJorba RBekheit MMartinez-Cecilia DParra-Membrives PSgourakis GMattila ABove AQuaresima SBarreras González JESharma ARuiz JJSánchez-Bueno FRobles-Campos RMartinez-Isla A
    Abstract:
    Background: Recently there has been a growing interest in the laparoscopic management of common bile duct stones with gallbladder in situ (LBDE), which is favoring the expansion of this technique. Our study identified the standardization factors of LBDE and its implementation in the single-stage management of choledocholithiasis. Methods: A retrospective multi-institutional study among 17 centers with proven experience in LBDE was performed. A cross-sectional survey consisting of a semi-structured pretested questionnaire was distributed covering the main aspects on the use of LBDE in the management of choledocholithiasis. Results: A total of 3950 LBDEs were analyzed. The most frequent indication was jaundice (58.8%). LBDEs were performed after failed ERCP in 15.2%. The most common approach used was the transcystic (63.11%). The overall series failure rate of LBDE was 4% and the median rate for each center was 6% (IQR, 4.5-12.5). Median operative time ranged between 60-120 min (70.6%). Overall morbidity rate was 14.6%, with a postoperative bile leak and complications ≥3a rate of 4.5% and 2.5%, respectively. The operative time decreased with experience (P =.03) and length of hospital stay was longer in the presence of a biliary leak (P =.04). Current training of LBDE was defined as poor or very poor by 82.4%. Conclusion: Based on this multicenter survey, LBDE is a safe and effective approach when performed by experienced teams. The generalization of LBDE will be based on developing training programs.
  • Others:

    Author, as appears in the article.: Lopez-Lopez V; Gil-Vazquez PJ; Ferreras D; Nassar AHM; Bansal VK; Topal B; Zhu JG; Chuang SH; Jorba R; Bekheit M; Martinez-Cecilia D; Parra-Membrives P; Sgourakis G; Mattila A; Bove A; Quaresima S; Barreras González JE; Sharma A; Ruiz JJ; Sánchez-Bueno F; Robles-Campos R; Martinez-Isla A
    Department: Medicina i Cirurgia
    URV's Author/s: Jorba Martin, Rosa Maria
    Keywords: Lithiasis Laparoscopy Endoscopic stone extraction Cystic duct Biliary tract Bile duct exploration metaanalysis lithiasis laparoscopy cystic duct cholecystectomy biliary tract 2-stage
    Abstract: Background: Recently there has been a growing interest in the laparoscopic management of common bile duct stones with gallbladder in situ (LBDE), which is favoring the expansion of this technique. Our study identified the standardization factors of LBDE and its implementation in the single-stage management of choledocholithiasis. Methods: A retrospective multi-institutional study among 17 centers with proven experience in LBDE was performed. A cross-sectional survey consisting of a semi-structured pretested questionnaire was distributed covering the main aspects on the use of LBDE in the management of choledocholithiasis. Results: A total of 3950 LBDEs were analyzed. The most frequent indication was jaundice (58.8%). LBDEs were performed after failed ERCP in 15.2%. The most common approach used was the transcystic (63.11%). The overall series failure rate of LBDE was 4% and the median rate for each center was 6% (IQR, 4.5-12.5). Median operative time ranged between 60-120 min (70.6%). Overall morbidity rate was 14.6%, with a postoperative bile leak and complications ≥3a rate of 4.5% and 2.5%, respectively. The operative time decreased with experience (P =.03) and length of hospital stay was longer in the presence of a biliary leak (P =.04). Current training of LBDE was defined as poor or very poor by 82.4%. Conclusion: Based on this multicenter survey, LBDE is a safe and effective approach when performed by experienced teams. The generalization of LBDE will be based on developing training programs.
    Thematic Areas: Surgery Medicina iii Medicina ii Medicina i Hepatology General medicine Gastroenterology & hepatology
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: rosamaria.jorba@urv.cat
    Author identifier: 0000-0003-3307-4340
    Record's date: 2024-09-07
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://onlinelibrary.wiley.com/doi/full/10.1002/jhbp.1123
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Journal Of Hepato-Biliary-Pancreatic Sciences. 29 (12): 1283-1291
    APA: Lopez-Lopez V; Gil-Vazquez PJ; Ferreras D; Nassar AHM; Bansal VK; Topal B; Zhu JG; Chuang SH; Jorba R; Bekheit M; Martinez-Cecilia D; Parra-Membrives (2022). Multi-institutional expert update on the use of laparoscopic bile duct exploration in the management of choledocholithiasis: Lesson learned from 3950 procedures. Journal Of Hepato-Biliary-Pancreatic Sciences, 29(12), 1283-1291. DOI: 10.1002/jhbp.1123
    Article's DOI: 10.1002/jhbp.1123
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2022
    Publication Type: Journal Publications
  • Keywords:

    Gastroenterology & Hepatology,Hepatology,Surgery
    Lithiasis
    Laparoscopy
    Endoscopic stone extraction
    Cystic duct
    Biliary tract
    Bile duct exploration
    metaanalysis
    lithiasis
    laparoscopy
    cystic duct
    cholecystectomy
    biliary tract
    2-stage
    Surgery
    Medicina iii
    Medicina ii
    Medicina i
    Hepatology
    General medicine
    Gastroenterology & hepatology
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