Advantages of laparoscopic stented choledochorrhaphy. Six years experience
David Martínez Cecilia (a),Víctor Valentí Azcárate (b), Kamran Qurashi (c), Ana García Agustí (c) y Alberto Martínez Isla (c)
Background: Laparoscopic common bile duct exploration (LCBDE) is nowadays a valid option in the management of common bile duct stones. T tube and primary closure have been used to close the choledochotomy, but these methods are not free of complications. We present our experience with the stented choledochorrhaphy.
Material and method: We retrospectively reviewed the data of 104 patients, who underwent LCBDE between January 1999 and February 2007. T tube was used in the first period. From July 2001 the method of choice has been the closure of the CBD over an endoprosthesis placed under direct view and later removed by gastroscopy.
Results: The technique was performed on 70 consecutive patients. Median operation time was 90 minutes. There was no conversion to open surgery. Stones could not be retrieved in 4.2% of patients. The median hospital stay was 4 days. Morbidity was 7%, although only 2.8% was related to the stent (acute pancreatitis). Postoperative mortality was 1.4%.
Conclusions: The stented laparoscopic choledochorrhaphy allows an efficient biliary decompression, and seems to avoid the complications of the T tube and primary closure. This method should be considered as a valid option after choledochotomy.