caa a22 4500 477036503 CHVBK 20180405111306.0 cr unu---uuuuu 170330e19960601xx s 000 0 eng 10.1007/s002689900083 doi (NATIONALLICENCE)springer-10.1007/s002689900083 Laparoscopic Treatment of Gallbladder and Common Bile Duct Stones: A Prospective Study [Elektronische Daten] [Emanuele Lezoche, Alessandro M. Paganini, Francesco Carlei, Francesco Feliciotti, Davide Lomanto, Mario Guerrieri] The aim of this study was to investigate prospectively the feasibility, success rate, safety, and short-term results of single-stage laparoscopic treatment of gallstones and ductal stones in 100 consecutive, unselected patients. Common bile duct (CBD) stones were diagnosed at routine intraoperative cholangiography and choledochoscopy in 100 of 950 patients with gallstones undergoing laparoscopic cholecystectomy (LC). Unsuspected CBD stones were present in 39 patients (4.1% of 950; 39% of 100); 26 patients were referred for surgery after failed endoscopic sphinctertomy (ES) performed elsewhere. Transcystic duct CBD exploration (TC-CBDE) was the procedure of choice. When it was not feasible, choledochotomy and direct CBD exploration (D-CBDE) was performed. Use of biliary drainage was liberal. A completion cholangiogram was obtained for all patients. Laparoscopic treatment of CBD stones was successful in 96 patients: after TC-CBDE in 63 and after D-CBDE in 33. Four operations were converted to open surgery (4%). Retained stones, observed in five patients, were treated by ES in two cases and by percutaneous endoscopic/fluoroscopic lithotripsy in three. Minor morbidity included biloma (n = 2), port site infection (n = 2), and subumbilical hematoma (n = 1). Major morbidity was bile leakage from the cystic duct stump in two cases due to clips or transcystic duct drainage displacement, respectively. One elderly, high risk patient died after being referred for several failed attempts of endoscopic clearance; she died from cardiogenic shock 3 days after successful laparoscopic treatment. Laparoscopic CBD exploration is feasible and safe in most patients, with short-term results that compare favorably with the results of sequential ES/LC reported in the literature. Société Internationale de Chirugie, 1996 Lezoche Emanuele Department of General Surgery I, Division of Surgical Pathology, Institute of Surgical Science, University of Ancona, Umberto I Hospital, Piazza Cappelli 1, 60121, Ancona, Italy aut Paganini Alessandro M. Department of General Surgery I, Division of Surgical Pathology, Institute of Surgical Science, University of Ancona, Umberto I Hospital, Piazza Cappelli 1, 60121, Ancona, Italy aut Carlei Francesco Department of Endocrinologic Surgery, University of L'Aquila, Viale della Croce Rosa, 67100, L'Aquila, Italy aut Feliciotti Francesco Department of General Surgery I, Division of Surgical Pathology, Institute of Surgical Science, University of Ancona, Umberto I Hospital, Piazza Cappelli 1, 60121, Ancona, Italy aut Lomanto Davide Institute of Second Surgical Clinic, University of Rome, "La Sapienza,”, Viale del Policlinico, 00161, Rome, Italy aut Guerrieri Mario Department of General Surgery I, Division of Surgical Pathology, Institute of Surgical Science, University of Ancona, Umberto I Hospital, Piazza Cappelli 1, 60121, Ancona, Italy aut World Journal of Surgery Springer-Verlag 20/5(1996-06-01), 535-542 0364-2313 20:5<535 1996 20 268 https://doi.org/10.1007/s002689900083 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900083 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lezoche Emanuele Department of General Surgery I, Division of Surgical Pathology, Institute of Surgical Science, University of Ancona, Umberto I Hospital, Piazza Cappelli 1, 60121, Ancona, Italy aut NATIONALLICENCE 700 1- Paganini Alessandro M. Department of General Surgery I, Division of Surgical Pathology, Institute of Surgical Science, University of Ancona, Umberto I Hospital, Piazza Cappelli 1, 60121, Ancona, Italy aut NATIONALLICENCE 700 1- Carlei Francesco Department of Endocrinologic Surgery, University of L'Aquila, Viale della Croce Rosa, 67100, L'Aquila, Italy aut NATIONALLICENCE 700 1- Feliciotti Francesco Department of General Surgery I, Division of Surgical Pathology, Institute of Surgical Science, University of Ancona, Umberto I Hospital, Piazza Cappelli 1, 60121, Ancona, Italy aut NATIONALLICENCE 700 1- Lomanto Davide Institute of Second Surgical Clinic, University of Rome, "La Sapienza,”, Viale del Policlinico, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Guerrieri Mario Department of General Surgery I, Division of Surgical Pathology, Institute of Surgical Science, University of Ancona, Umberto I Hospital, Piazza Cappelli 1, 60121, Ancona, Italy aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 20/5(1996-06-01), 535-542 0364-2313 20:5<535 1996 20 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer