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

  • Datos identificativos

    Identificador: imarina:9245942
    Autores:
    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
    Resumen:
    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.
  • Otros:

    Autor según el artículo: 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
    Departamento: Medicina i Cirurgia
    Autor/es de la URV: Jorba Martin, Rosa Maria
    Palabras clave: Lithiasis Laparoscopy Endoscopic stone extraction Cystic duct Biliary tract Bile duct exploration metaanalysis lithiasis laparoscopy cystic duct cholecystectomy biliary tract 2-stage
    Resumen: 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.
    Áreas temáticas: Surgery Medicina iii Medicina ii Medicina i Hepatology General medicine Gastroenterology & hepatology
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    Direcció de correo del autor: rosamaria.jorba@urv.cat
    Identificador del autor: 0000-0003-3307-4340
    Fecha de alta del registro: 2024-09-07
    Versión del articulo depositado: info:eu-repo/semantics/publishedVersion
    Enlace a la fuente original: https://onlinelibrary.wiley.com/doi/full/10.1002/jhbp.1123
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referencia al articulo segun fuente origial: Journal Of Hepato-Biliary-Pancreatic Sciences. 29 (12): 1283-1291
    Referencia de l'ítem segons les normes 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
    DOI del artículo: 10.1002/jhbp.1123
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2022
    Tipo de publicación: Journal Publications
  • Palabras clave:

    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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