The management of combined gall stones and CBD stones should include removal of thegallbladder and clearance of the duct system which can be achieved by ERCP and extraction of stones before operation or directly with laparoscopic cholecystectomy (LC) and laparoscopic common duct exploration (LCDE). LCDE is well accepted by patients because treatment is obtained during the same anesthesia.
:Aim
To assess the technical feasibility and potential advantages of LCDE and to report this initial experience at our institute.
:Patients & methods
From January 2011 to October 2014, 30 patients with CBD stones were prospectively treated by LC and LCDE at Sohag University Hospital, Upper Egypt.
:Results
This study included 28 females and 2 males, age ranged from 25-85 years. 25 patients were presented by biliary colic and 5 with jaundice. Mean CBD diameter was 13.3 (range 8-25) mm. CBD stones were single in 20 cases, double in 2 and multiple in 8. Direct choledochotomy approach was performed in 27 patients and transcystic approach in 3. Clearance of stones was achieved laparoscopically by combination of wash, Dormia basket and balloon extraction in 27 patients, 3 were converted to open. Closure of CBD was done over T-tube in 17 cases and primarily in 10. Mean operative time was 127 (range 90-210) minutes. No intraoperative complications. Post-operative complications occurred only in 3 cases (3 biliary leakages & one localized intra-peritoneal collection). No mortality. Mean hospital stay was 8.4 (range 5-15) days.
:Conclusion
LCDE during LC solves 2 problems during the same anesthesia with high success and low morbidity and mortality rates.