Buscar en
Cirugía Española (English Edition)
Toda la web
Inicio Cirugía Española (English Edition) Laparoscopic Choledochoduodenostomy
Journal Information
Share
Share
Download PDF
More article options
Visits
3848
Original article
Laparoscopic Choledochoduodenostomy
Colédoco-duodeno anastomosis laparoscópica
Visits
3848
Adolfo Cuendis-Velázquez, Mario E. Trejo-Ávila
Corresponding author
mario.trejo.avila@gmail.com

Corresponding author.
, Enrique Rosales-Castañeda, Eduardo Cárdenas-Lailson, Martin E. Rojano-Rodríguez, Sujey Romero-Loera, Carlos A. Sanjuan-Martínez, Mucio Moreno-Portillo
Servicio de Cirugía General y Endoscópica, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
This item has received
Received 09 January 2017. Accepted 03 July 2017
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Tables (3)
Table 1. Characteristics of Bile Duct Pathologies of the Study Population, Preoperative Values.
Table 2. Immediate Surgical Results and Follow-Up in Patients With LCDD.
Table 3. Hepatic Enzyme Levels: Preoperative, Postoperative and Outpatient Follow-Up.
Show moreShow less
Abstract
Introduction

Today's options for biliary bypass procedures, for difficult choledocholithiasis, range from open surgery to laparo-endoscopic hybrid procedures. The aim of this study was to analyze the outcomes of patients with difficult choledocholithiasis treated with laparoscopic choledochoduodenostomy.

Methods

We performed a prospective observational study from March 2011 to June 2016. We included patients with difficult common bile duct stones (recurrent or unresolved by ERCP) in which a biliary bypass procedure was required. We performed a laparoscopic bile duct exploration with choledochoduodenostomy and intraoperative cholangioscopy.

Results

A total of 19 patients were included. We found female predominance (78.9%), advanced mean age (72.4±12 years) and multiple comorbidities. Most patients with previous episodes of choledocholitiasis or cholangitis, mode 1 (min-max: 1–7). Mean common bile duct diameter 24.9±7mm. Mean operative time 218.5±74min, estimated blood loss 150 (30–600)mL, resume of oral intake 3.2±1 days, postoperative length of stay 4.9±2 days. We found a median of 18 (12–32) months of follow-up. All patients with normalization of liver enzymes during follow-up. One patient presented with sump syndrome and one patient died due to nosocomial pneumonia.

Conclusions

Laparoscopic choledochoduodenostomy with intraoperative cholangioscopy seems to be safe and effective treatment for patients with difficult common bile duct stones no resolved by endoscopic procedures. This procedure is a good option for patients with advanced age and multiple comorbidities. We offer all the advantages of minimally invasive surgery to these patients.

Keywords:
Laparoscopic choledochoduodenostomy
Difficult common bile duct stones
Cholangioscopy
Sump syndrome
Resumen
Introducción

Las opciones actuales para realizar procedimientos permanentes de derivación biliodigestiva, secundarios a coledocolitiasis compleja, van desde la cirugía abierta hasta el empleo de procedimientos híbridos laparoendoscópicos. El objetivo del estudio fue realizar un análisis de los resultados obtenidos en pacientes con coledocolitiasis compleja tratados con colédoco-duodeno anastomosis laparoscópica.

Métodos

Se realizó un estudio observacional longitudinal en el período comprendido de marzo de 2011 a junio de 2016. Se incluyeron pacientes con coledocolitiasis compleja no resuelta por CPRE o resueltas por CPRE pero con dilatación masiva de vía biliar y evidencia de colestasis persistente, los cuales fueron seleccionados para procedimiento quirúrgico con colédoco-duodeno anastomosis.

Resultados

Se incluyeron un total de 19 pacientes. La mayoría mujeres (78,9%), con edad media avanzada (72,4±12 años) y con múltiples comorbilidades. Todos con al menos un episodio (mín-máx: 1-7) de coledocolitiasis o colangitis previos. El diámetro del colédoco fue de 24,9±7mm. El tiempo quirúrgico fue de 218,5±74min, sangrado de 150 (30-600)mL, inicio de dieta en 3,2±1 días y estancia hospitalaria postoperatoria de 4,9±2 días. Se encontró una mediana de 18 (12-32) meses de seguimiento. Posterior al procedimiento se observó normalización de las pruebas de funcionamiento hepático. Un paciente presentó síndrome del sumidero y un paciente falleció por neumonía nosocomial.

Conclusiones

La colédoco-duodeno anastomosis laparoscópica asistida con coledocoscopia representa una técnica segura y eficaz para el tratamiento de pacientes con coledocolitiasis compleja con indicación de derivación biliodigestiva, ofreciendo los beneficios de la cirugía de mínima invasión.

Palabras clave:
Colédoco-duodeno anastomosis laparoscópica
Coledocolitiasis compleja
Colangioscopia
Coledocoscopia
Síndrome del sumidero

Article

These are the options to access the full texts of the publication Cirugía Española (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Cirugía Española (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos