Laparoscopic choledochoduodenostomy as an optional treatment for complex choledocholithiasis
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چکیده
introduction: Choledochoduodenostomy is indicated for unresolved choledocholithiasis and biliary malignant or benign stenosis. This surgical procedure has been feared due to its potential complications. This article demonstrates our initial experience with this laparoendoscopic approach. methods: We performed laparoscopic choledochoduodenostomy in seven elderly patients with recurrent or unresolved choledocholithiasis. Additionally, laparo-endoscopic extraction of gallstones was performed in cases where necessary. We gathered and analyzed the demographic data, diagnostic evidence and follow-up of the patients. results: Average age of patients was 71 years, with 57.1% of females in our population. Main comorbidities of our patients included obesity (71.4%), type 2 diabetes mellitus (57.4%), and arterial hypertension (42.85%). Patients had on average 2.7 previous episodes of choledocholithiasis and/or cholangitis and the average diameter of the removed stones was 22.6 mm. Average follow-up was 155 days (range: 28-420). discussion: Laparoscopic choledochoduodenostomy has proven to be safe, effective and superior to open surgery. Appropriate patient selection and surgeon experience in laparoscopic techniques are necessary. All these factors reduce long-term complications that have been related to this surgical procedure. Conclusions: Laparoscopic choledochoduodenostomy is an option for the definitive surgical treatment of “difficult choledocholithiasis” in elderly patients with multiple comorbidities while offering advantages of minimally invasive approaches.
منابع مشابه
Laparoscopic Choledochoduodenostomy in the Management of Obstructive Biliary Tract in the ERCP Era
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متن کاملCholedocholithiasis: Treatment Options in a Tertiary Care Setup in Pakistan
Introduction Among patients with cholelithiasis, choledocholithiasis may also be present in about 18% of cases. They can be treated through various endoscopic, laparoscopic, and open surgical procedures. Objective The objective of this study was to determine the outcome of patients with choledocholithiasis being treated in our setup. Methods This descriptive case series was conducted at Holy Fa...
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تاریخ انتشار 2014