Choledocholithiasis-a New Clinical Pathway

Overview

Journal Transl Gastroenterol Hepatol

Publisher AME Publishing Company

Specialty Gastroenterology

Date 2021 Aug 23

PMID 34423156

Citations 9

Authors

Maggie E Bosley

Irving J Zamora

Lucas P Neff

Affiliations

Soon will be listed here.

Abstract

The incidence of cholecystectomy in children has increased considerably since the early 1990s. Management of gallbladder disease in children must include an awareness of choledocholithiasis treatment strategies. Both endoscopic retrograde cholangiopancreatography (ERCP) and common bile duct exploration (open or laparoscopic) are accepted management techniques for choledocholithiasis. Laparoscopic cholecystectomy with preoperative or postoperative ERCP is at least a two-procedure process while cholecystectomy with laparoscopic common bile duct exploration (LCBDE) can provide definitive treatment in a single procedure under one anesthetic. Despite this, the trend over the last decade continues towards less LCBDE utilization in favor of ERCP. This trend has resulted in decreased familiarity with LCBDE by adult and pediatric surgeons and their trainees. Access to the necessary tools and education on the technical aspects can allow for successful single-stage treatment of choledocholithiasis by surgeons during laparoscopic cholecystectomy. This may include a pre-defined stepwise algorithm and understanding of all the equipment and resources necessary to perform a LCBDE. Ultimately, increased understanding of the equipment and procedural steps necessary for LCBDE will result in widened adoption of the technique and thus confer advantages to the patient such as decreased length of stay and fewer required anesthetics.

Citing Articles

Laparoendoscopic Rendezvous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis in Selected Patients.

Percario R, Panaccio P, Caldarella M, Trappoliere M, Marino M, Farrukh M J Clin Med. 2025; 14(4).

PMID: 40004839 PMC: 11856840. DOI: 10.3390/jcm14041310.

Laparoscope combined with ureteroscope in the treatment of bile duct stones and cholecystolithiasis in a child: a case report and literature review.

Fu C, Jin H, Fang L, Xu H Front Med (Lausanne). 2024; 11:1429127.

PMID: 39421867 PMC: 11483362. DOI: 10.3389/fmed.2024.1429127.

Laparoscopic cholecystectomy for symptomatic cholelithiasis in children and adolescents: analysis of 50 cases from a single institution.

Almeida R, Gerardi Filho V, Dias J, Peres M, Waisberg J Acta Cir Bras. 2024; 39:e394124.

PMID: 39046043 PMC: 11262753. DOI: 10.1590/acb394124.

Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP.

Gomes A, Haidar A, Padilha G, Bara J, Nonato M, Rodrigues J BMC Gastroenterol. 2023; 23(1):419.

PMID: 38030984 PMC: 10687980. DOI: 10.1186/s12876-023-03013-w.

The Laparoscopy in Biliary Exploration Research and Training Initiative (LIBERTI) trial: simulator-based training for laparoscopic management of choledocholithiasis.

Vandruff V, Santos B, Kuchta K, Cotter R, Goldwag J, Cai M Surg Endosc. 2023; 38(2):931-941.

PMID: 37910247 DOI: 10.1007/s00464-023-10480-5.

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