Abstract
Background:
Laparoscopic common bile duct exploration (LCBDE) is becoming more popular in the management of choledocholithiasis due to improved laparoscopic expertise and advancement in endoscopic technology and equipment.
Objective:
The aim of this work is to assess the technical feasibility of exploration of the common bile duct (CBD) by means of laparoscopy and to evaluate its potential advantages in management of bile duct stones.
Methods:
This prospective study was conducted at department of surgery, Sohag University hospital. It included 30 patients who underwent LECBD from March 2011 to October 2014.
Results:
The male/female ratio was 2/28 and mean age was 48 (range from 25-85) years. The main presentation was biliary colic in 25 (83%) patients, 16(53.3%) of them had raise total and direct bilirubin (subclinical jaundice), and jaundice in 5 (17%). LCBDE was completed in 27 (90%) patients and 3 (10%) had open conversion. 27 cases were managed through choledochotomy incision and 3 using a transcystic approach. Stone clearance was successful in all patients by use of wash, dormia basket and balloon extraction through choledocosopy. Choledochotomy repair using T-tube drainage done in 17 (62%) patients and primary closure in 10 (37%). The mean operative time was 127 (range from 90-120) minutes, and hospital stay was 8 (range from 5-15) days. Apart from postoperative biliary leakage in 3 (10%) cases no other complications detected.
Conclusions:
LCBDE it is technically feasible with high success rate and well accepted by the patients as it solves 2 problems during the same anesthesia