Laparoscopic common bile duct exploration in cirrhotic patients with choledocholithiasis

• Published in: Surgical laparoscopy, endoscopy & percutaneous techniques Vol. 25; no. 1; p. 64
• Main Authors: Qiu, Jianguo, Yuan, Haichao, Chen, Shuting, Wu, Hong
• Format: Journal Article
• Language: English
• Published: United States 01.02.2015
• Subjects: Adult; Aged; Choledocholithiasis - complications; Choledocholithiasis - diagnosis; Choledocholithiasis - surgery; Feasibility Studies; Female; Humans; Laparoscopy; Length of Stay; Liver Cirrhosis - complications; Liver Cirrhosis - pathology; Male; Middle Aged; Operative Time; Patient Selection; Retrospective Studies; Treatment Outcome
• ISSN: 1534-4908
• DOI: 10.1097/SLE.0000000000000018

Although laparoscopic common bile duct exploration (LCBDE) has become the standard procedure for most choledocholithiasis patients, the application of this procedure to liver cirrhosis is still in debate. The aim of current study was to evaluate the feasibility and safety of LCBDE in choledocholithiasis patients with compensated liver cirrhosis. From January 2006 to December 2012, 346 LCBDE performed in our hospital. According to previous defined liver condition, the patients were divided into group A (liver cirrhosis, n=132) and group B (without cirrhosis, n=214). The perioperative data for the 2 groups were retrospectively reviewed and compared. LCBDE was successfully completed in 326 patients. Conversion from laparoscopic to open surgery was necessary for 20 patients (5.7%) mainly because of hemorrhage (5, 25%) and severe adhesions (8, 40%); a T-tube was placed in 211 patients (64.7%), and primary closure was done in 115 (35.3%). There was significant difference for groups A and B in term of intraoperative blood loss (85 vs. 35 mL; P<0.01). However, the 2 groups showed no significant differences with respect to mean operation time (2.1 vs. 1.9 h; P=0.07), complication rates (10.6% vs. 8.8%; P=0.6), and mean hospital stay (4.2 vs. 4.0 d; P=0.6), conversion rate (5.3% vs. 6.1%; P=0.77), and retained choledocholithiasis rate (8.3% vs. 7.1%; P=0.65). There was no mortality in both the groups. LCBDE is a feasible, effective, and safe surgical procedure for choledocholithiasis patients with compensated cirrhosis.