Sequential Intraluminal Endoscopic and Laparoscopic Treatment for Bile Duct Stones Associated with Gallstones

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 1996 Jun 1

PMID 8662404

Authors

G Zaninotto

M Costantini

M Rossi

M Anselmino

S Pianalto

D Oselladore

D Pizzato

L Norberto

E Ancona

Affiliations

Soon will be listed here.

Abstract

Background: On the basis of a flowchart including prior or current jaundice or pancreatitis, abnormal liver function, ultrasound or IV cholangiography, bile duct (BD) stones were suspected in 71/593 patients referred for gallstones.

Methods: When endoscopic retrograde cholangiography detected BD stones, endoscopic sphincterotomy (ES) and endoscopic BD clearance were attempted, followed by laparoscopic cholecystectomy (LC). BD stones were found in 44/71 patients. The sensitivity values of preoperative conditions were: 92% for IV cholangiography, 88% for abnormal liver function, 50% for ultrasound, and 37% for jaundice at admission.

Results: Endoscopic clearance succeeded in 37 patients and LC was completed in 33 patients. Conversion to open surgery (9%) was comparable with the rate in patients without BD stones. The median hospital stay for the sequential endoscopic and laparoscopic treatments was 13 days (range 4-54) or 22 days if open surgery was used.

Conclusions: In conclusion, BD stones can be endoscopically cleared preoperatively in most patients without interfering with LC.

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