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Cirugía Española (English Edition) Transcystic approach in the management of choledocholithiasis: Intraoperative co...
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Innovation in surgical technique

Transcystic approach in the management of choledocholithiasis: Intraoperative complications and technical considerations

Abordaje transcístico en el manejo de la coledocolitiasis: complicaciones intraoperatorias y consideraciones técnicas
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Ana Belén Martín Arnaua,b,
Corresponding author
amartinar@santpau.cat

Corresponding author.
, Luis Enrique García San Joséb, Víctor Molina Santosa,b, Santiago Sánchez-Cabúsa,b
a HBP Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
b Department of General Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Abstract

The management of choledocholithiasis has evolved with the introduction of new technologies and the training of specialists. However, there is still debate regarding the most appropriate approach for this condition, with several options available for the management of cholelithiasis with concomitant choledocholithiasis. A multitude of studies have emerged supporting the transcystic approach, highlighting its excellent results in terms of lower morbidity, shorter hospital stays, reduced costs, and successful resolution of choledocholithiasis. This has led to an increase in the use of this approach compared to the transductal approach. Given the rise in the practice of this technique over the past decade, it is essential to be aware of the intrinsic complications associated with the technique, which are less documented in the literature compared to postoperative complications. This awareness will enable surgeons who are new to this technique to identify and address such complications, thereby contributing to an increased success rate.

Keywords:
Transcystic approach
Choledocholithiasis
Intraoperative complications
Resumen

El manejo de la coledocolitiasis ha evolucionado con la introducción de nuevas tecnologías y la formación de especialistas. Sin embargo, aún existe debate sobre cuál debe ser el enfoque adecuado para esta patología, existiendo varias opciones para el manejo de la colelitiasis con coledocolitiasis concomitante. Han surgido multitud de estudios que apoyan el abordaje transcístico destacando sus excelentes resultados en términos de menor morbilidad, menor estancia hospitalaria, disminución de costes, así como resolución de la coledocolitiasis, lo que ha incrementado la tasa de realización de este abordaje en comparación con el transductal. Considerando el incremento en la práctica de este abordaje en la última década, es fundamental conocer las complicaciones intrínsecas a la técnica, menos documentadas en la literatura en comparación con las complicaciones postoperatorias. Esto permitirá a los cirujanos que se inician en esta técnica a identificar y resolver dichas complicaciones, contribuyendo así a aumentar el porcentaje de éxito.

Palabras clave:
Abordaje transcístico
Coledocolitiasis
Complicaciones intraoperatorias

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