Review
Copyright ©The Author(s) 2019.
World J Gastroenterol. Apr 7, 2019; 25(13): 1531-1549
Published online Apr 7, 2019. doi: 10.3748/wjg.v25.i13.1531
Table 1 Important documents for laparoscopic choledocholithotomy
Reference numberRemarks
[7,8,14,32-24]Experience alone is not enough to ensure successful performance of laparoscopic surgeries.
[7,30,84]The right upper quadrant provides a suitable location for the surgical field in laparoscopic procedures.
[22,23]Technical challenges have prevented laparoscopic surgeries for the EHBD (e.g., choledocholithotomy and choledochojejunostomy) from gaining worldwide popularity.
[26-28,30,31,56,59]Laparoscopic choledocholithotomy provides safe and feasible treatment for recurrent stones and associated cholangitis.
[22,26-28,110,111]For acute cholangitis and bile duct stone, one-stage laparoscopic choledocholithotomy has excellent clinical outcomes and cost-effectiveness.
[19,45]For patients with acute cholangitis, biliary drainage should be performed as soon as possible.
Risk factors for general anesthesia should be completely removed by preoperative biliary drainage.
[45]Transpapillary biliary drainage without EST (i.e., nasobiliary drainage or biliary stenting) should be performed initially as an emergent therapy for acute cholangitis.
For patients with acute cholangitis, EST is not routinely recommended for biliary drainage alone.
[20]Ill-considered use of EST should be avoided.
[28,56-59]Acute cholangitis and bile duct stones are critical problems in a patient after abdominal surgery.
[28,59]Laparoscopic approach is advantageous even for reoperative choledocholithotomy in a patient with a past history of laparotomy.
[62]Cholecystectomy after EST for biliary duct stones does not reduce the incidence of recurrent cholangitis.
[22]Transcystic C-tube drainage has a lower complication rate than transductal T-tube drainage or EST.
[69]Previously, choledocholithotomy via conventional open surgery with transductal T-tube drainage versus laparoscopic primary closure with transcystic C-tube drainage remains controversial.
[22,27,69,106-109]Currently, laparoscopic choledocholithotomy with primary closure and transcystic C-tube drainage is superior to conventional open surgery with transductal T-tube drainage.
[47,49,70]Currently, HBP surgeons intend to end the use of transductal T-tube drainage.
[73,74]Operative time is greatly affected by the duration of stone removal.
[77,78]Detailed preoperative investigation is important for successful laparoscopic choledocholithotomy with a shortened operative time.
[91-93]The method of primary closure of the transductal incision is chosen according to the EHBD diameter.
[32]Cautery-induced injury results in necrotizing loss of ductal and/or perivascular tissues.
Anatomical misidentificaion should be avoided.