Laparoscopic Cholecystectomy and Common Bile Duct Exploration Using Choledochotomy and Primary Closure Following Failed Endoscopic Retrograde Cholangiopancreatography: A Multicentric Comparative Study Using Three-port vs Multiport
Mauricio Pedraza, Luis F Cabrera, Daniel A Gomez, Andres C Mendoza-Zuchini, Jean A Pulido, Maria C Jiménez, Ricardo A Villarreal, Sebastian Sanchez-Ussa
Common bile duct stones, Laparoscopic cholecystectomy, Laparoscopic common bile duct exploration
Citation Information :
Pedraza M, Cabrera LF, Gomez DA, Mendoza-Zuchini AC, Pulido JA, Jiménez MC, Villarreal RA, Sanchez-Ussa S. Laparoscopic Cholecystectomy and Common Bile Duct Exploration Using Choledochotomy and Primary Closure Following Failed Endoscopic Retrograde Cholangiopancreatography: A Multicentric Comparative Study Using Three-port vs Multiport. World J Lap Surg 2020; 13 (1):4-10.
Background: Laparoscopic surgery has changed many ways in which we as surgeons manage patients, offering better results, quicker recovery, and fewer complications using minimally invasive techniques, especially in common bile duct (CBD) surgery. Not only can laparoscopic techniques be applied to programed surgery but also emergencies and those following failed endoscopic retrograde cholangiopancreatography (ERCP). Objectives and aims: Describe and compare clinical and surgical results of the laparoscopic CBD exploration with primary closure using a 3-port vs multiport approach. Materials and methods: We present a multicentric comparative study of 197 consecutive patients who underwent a laparoscopic gallbladder removal along with CBD exploration with primary closure following failed (ERCP to extract CBD stones; 104 patients were managed by three-port vs 93 multiport laparoscopic surgery in five centers of Bogotá, Colombia, between 2013 and 2017 with follow-up of 1 year. Results: A total of 197 patients were taken to laparoscopic gallbladder removal along with CBD exploration with primary closure, 104 patients via three-port technique and 93 patients via multiport. All (100%) the patients had previously failed ERCP. The average surgical time on the three-port approach was 106 minutes vs 123 minutes on multiport. Only in the multiport technique we had an average conversion of 2%. Mean hospital stay of 2.5 days, less for the three-port approach vs multiport in 5–7 days. There was a need of reintervention in 1% of the patients who underwent three-port exploration. Conclusion: Postoperative pain, use of an additional port, complication rates, operation time, and cost of the three-port technique were similar to those of the conventional approach. Large randomized controlled trials are needed to examine the true benefits of the three-port technique.
Mouret P. How I developed laparoscopic cholecystectomy. Ann Acad Med Singapore 1996;25:744–774.
Akoglu M, Bostanci EB, Colakoglu MK. Three-port, two located on the Pfannenstiel line, laparoscopic cholecystectomy comparison with traditional laparoscopic cholecystectomy. Am Surg 2017;83(3):260–264.
Dasari BV, Tan CJ, Gurusamy KS, et al. Surgical versus endoscopic treatment of bile duct stones. In: Dasari BV. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2013. p. CD003327. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23999986.
Buxbaum J. Modern management of common bile duct stones. Gastrointest Endosc Clin N Am [Internet] 2013;23(2):251–275. DOI: 10.1016/j.giec.2012.12.003. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23540960.
Williams EJ, Green J, Beckingham I, et al. Guidelines on the management of common bile duct stones (CBDS). Gut [Internet] 2008;57(7):1004–1021. DOI: 10.1136/gut.2007.121657. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18321943.
Li K-Y, Shi C-X, Tang K, et al. Advantages of laparoscopic common bile duct exploration in common bile duct stones. Wien Klin Wochenschr [Internet], vol. 130, (3–4). Springer Vienna; 2018. pp. 100–104. Available from: http://link.springer.com/10.1007/s00508-017-1232-9.
Grubnik VV, Tkachenko AI, Ilyashenko VV, et al. Laparoscopic common bile duct exploration versus open surgery: comparative prospective randomized trial. Surg Endosc [Internet] 2012;26(8):2165–2171. DOI: 10.1007/s00464-012-2194-7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22350244.
Halawani HM, Tamim H, Khalifeh F, et al. Outcomes of laparoscopic vs open common bile duct exploration: analysis of the NSQIP database. J Am Coll Surg [Internet] 2017;224(5):833–840.e2. DOI: 10.1016/j.jamcollsurg.2017.01.062. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28279776.
Abellan Morcillo I, Qurashi K, Abrisqueta Carrión J, et al. Exploración laparoscópica de la vía biliar, lecciones aprendidas tras más de 200 casos. Cirugía Española [Internet] 2014;92(5):341–347. DOI: 10.1016/j.ciresp.2013.02.010. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24559592.
Chan DSY, Jain PA, Khalifa A, et al. Laparoscopic common bile duct exploration. Br J Surg [Internet] 2014;101(11):1448–1452. DOI: 10.1002/bjs.9604. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25123479.
Zhou Y, Wu X-D, Fan R-G, et al. Laparoscopic common bile duct exploration and primary closure of choledochotomy after failed endoscopic sphincterotomy. Int J Surg [Internet], vol. 12, (7). Elsevier; 2014. pp. 645–648. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24879343.
Tang S-T, Yang Y, Wang Y, et al. Laparoscopic choledochal cyst excision, hepaticojejunostomy, and extracorporeal Roux-en-Y anastomosis: a technical skill and intermediate-term report in 62 cases. Surg Endosc [Internet] 2011;25(2):416–422. DOI: 10.1007/s00464-010-1183-yAvailable from: http://www.ncbi.nlm.nih.gov/pubmed/20602140.
Chang J, Walsh RM, El-Hayek K. Hybrid laparoscopic-robotic management of type IVa choledochal cyst in the setting of prior Roux-en-Y gastric bypass: video case report and review of the literature. Surg Endosc [Internet] 2015;29(6):1648–1654. DOI: 10.1007/s00464-014-3937-4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25492448.
van Baal MC, Besselink MG, Bakker OJ, et al. Timing of cholecystectomy after mild biliary pancreatitis. Ann Surg [Internet] 2012;255(5):860–866. DOI: 10.1097/SLA.0b013e3182507646. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22470079.
Gigot JF, Navez B, Etienne J, et al. A stratified intraoperative surgical strategy is mandatory during laparoscopic common bile duct exploration for common bile duct stones. Lessons and limits from an initial experience of 92 patients. Surg Endosc [Internet] 1997;11(7):722–728. DOI: 10.1007/s004649900436. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9214319.
Salama AF, Abd Ellatif ME, Abd Elaziz H, et al. Preliminary experience with laparoscopic common bile duct exploration. BMC Surg [Internet] 2017;17(1):32. DOI: 10.1186/s12893-017-0225-y. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28359270.
Parra-Membrives P, Martínez-Baena D, Lorente-Herce JM, et al. Laparoscopic common bile duct exploration in elderly patients. Surg Laparosc Endosc Percutan Tech [Internet] 2014;24(4):e118–e122. DOI: 10.1097/SLE.0b013e31829012f6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24710237.
Topal B, Aerts R, Penninckx F. Laparoscopic common bile duct stone clearance with flexible choledochoscopy. Surg Endosc [Internet] 2007;21(12):2317–2321. DOI: 10.1007/s00464-007-9577-1. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17943379.
Chander J, Vindal A, Lal P, et al. Laparoscopic management of CBD stones: an Indian experience. Surg Endosc 2011;25(1):172–181. DOI: 10.1007/s00464-010-1152-5.
Wani MA, Chowdri NA, Naqash SH, et al. Closure of the common duct-endonasobiliary drainage tubes vs. T tube: a comparative study. Indian J Surg 2010;72(5):367–372. DOI: 10.1007/s12262-010-0122-4.
Khan M, Qadri SJF, Nazir SS. Use of rigid nephroscope for laparoscopic common bile duct exploration - a single-center experience. World J Surg 2010;34(4):784–790. DOI: 10.1007/s00268-010-0397-4.
Bandyopadhyay SK, Khanna S, Sen B, et al. Antegrade common bile duct (CBD) stenting after laparoscopic CBD exploration. J Minim Access Surg 2007;3(1):19–25. DOI: 10.4103/0972-9941.30682.
Tokumura H, Umezawa A, Cao H, et al. Laparoscopic management of common bile duct stones: Transcystic approach and choledochotomy. J Hepatobiliary Pancreat Surg 2002;9(2):206–212. DOI: 10.1007/s005340200020.
Yi HJ, Hong G, Min SK, et al. Long-term outcome of primary closure after laparoscopic common bile duct exploration combined with choledochoscopy. Surg Laparosc Endosc Percutan Tech [Internet] 2015;25(3):250–253. DOI: 10.1097/SLE.0000000000000151. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25856136.
Gurusamy KS, Koti R, Davidson BR. T-tube drainage versus primary closure after laparoscopic common bile duct exploration. Cochrane Database Syst Rev [Internet] 2013(6):CD005641. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23794201.
Podda M, Polignano FM, Luhmann A, et al. Systematic review with meta-analysis of studies comparing primary duct closure and T-tube drainage after laparoscopic common bile duct exploration for choledocholithiasis. Surg Endosc [Internet]. US: Springer; 2016;30(3):845–861. Available from: http://link.springer.com/10.1007/s00464-015-4303-x.
Zhang H-W, Chen Y-J, Wu C-H, et al. Laparoscopic common bile duct exploration with primary closure for management of choledocholithiasis: a retrospective analysis and comparison with conventional T-tube drainage. Am Surg [Internet] 2014;80(2):178–181. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24480219.
Zheng C, Huang Y, Xie E, et al. Laparoscopic common bile duct exploration: a safe and definitive treatment for elderly patients. Surg Endosc 2017;31(6):2541–2547. DOI: 10.1007/s00464-016-5257-3.
Zhou Y, Zha WZ, Wu XD, et al. Three modalities on management of choledocholithiasis: a prospective cohort study. Int J Surg 2017;44:269–273. DOI: 10.1016/j.ijsu.2017.06.032.
Platt TE, Smith K, Sinha S, et al. Laparoscopic common bile duct exploration; a preferential pathway for elderly patients. Ann Med Surg 2018;30:13–17. DOI: 10.1016/j.amsu.2018.03.044.
Hua J, Meng H, Yao L, et al. Five hundred consecutive laparoscopic common bile duct explorations: 5-year experience at a single institution. Surg Endosc 2017;31(9):3581–3589. DOI: 10.1007/s00464-016-5388-6.
Sharma PK, Mehta KS. Three port versus standard four port laparoscopic cholecystectomy-a prospective study. JK Science 2015;17(1):38.
Gurusamy KS, Vaughan J, Rossi M, et al. Fewer-than-four ports versus four ports for laparoscopic cholecystectomy. Cochrane Database Syst Rev 2014(2):CD007109–CD007109. DOI: 10.1002/14651858.CD007109.pub2.
Quaresima S, Balla A, Guerrieri M, et al. A 23 year experience with laparoscopic common bile duct exploration. HPB 2017;19(1):29–35. DOI: 10.1016/j.hpb.2016.10.011.
Ciftci A, Yazicioglu MB, Tiryaki C, et al. Is the fourth port routinely required for laparoscopic cholecystectomy? Our three-port laparoscopic cholecystectomy experience. Ir J Med Sci 2016;185(4):909–912. DOI: 10.1007/s11845-016-1493-8.