|
1
|
Ye YQ, Li PH, Wu Q, Yang SL, Zhuang BD, Cao YW, Xiao ZY, Wen SQ. Evolution of surgical treatment for hepatolithiasis. World J Gastrointest Surg 2024; 16:3666-3674. [PMID: 39734463 PMCID: PMC11650219 DOI: 10.4240/wjgs.v16.i12.3666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 08/27/2024] [Accepted: 10/11/2024] [Indexed: 11/27/2024] Open
Abstract
Hepatolithiasis is a common disease where stones are located in the intrahepatic bile duct. Hepatolithiasis is a disease with regional characteristics. The complication and postoperative recurrence rates of the disease are high. The intrahepatic cholangiocarcinoma and the incidence of liver cirrhosisare the main causes of death in patients with hepatolithiasis. Thus, it is difficult to treat. The majority of biliary stones are readily removed endoscopically, however complex intrahepatic or large refractory extrahepatic stones often require surgical or percutaneous interventions when standard endoscopic methods fail. At present, the main clinical treatment for hepatolithiasis is surgery, of which there are different methods depending on the patient's condition. With the continuous updates and development of medical technology, the treatment of hepatolithiasis has improved. In this paper, several mainstream surgical methods including partial hepatectomy, choledochojejunostomy, biliary tract exploration and lithotomy, percutaneous transhepatic chledochoscopic lithotripsy and liver transplantation used in the clinic are reviewed for clinicians' reference. Depending on the characteristics of each case, a suitable surgical method is chosen to obtain the best treatment effect.
Collapse
Affiliation(s)
- Yong-Qing Ye
- Department of Hepatobiliary Surgery, The Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China
| | - Pei-Heng Li
- Department of Oncology, Foshan Nanhai District Fifth People's Hospital, Foshan 528000, Guangdong Province, China
| | - Qing Wu
- Department of Hepatobiliary Surgery, The Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China
| | - Shang-Lin Yang
- Department of Hepatobiliary Surgery, The Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China
| | - Bao-Ding Zhuang
- Department of Hepatobiliary Surgery, The Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China
| | - Ya-Wen Cao
- Department of Emergency Medicine, Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
| | - Zhan-Yi Xiao
- Department of Hepatobiliary Surgery, The Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China
| | - Shun-Qian Wen
- Department of Hepatobiliary Surgery, The Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China
| |
Collapse
|
|
2
|
Lenz Virreira ME, Gasque RA, Cervantes JG, Mollard L, Ruiz NS, Beltrame MC, Mattera FJ, Quiñonez EG. Laparoscopic repair of bile duct injuries: Feasibility and outcomes. Cir Esp 2024; 102:127-134. [PMID: 38141844 DOI: 10.1016/j.cireng.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/19/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION Bile duct injuries (BDI) following laparoscopic cholecystectomy occurs in approximately 0.6% of the cases, often being more severe and complex. Roux-en-Y hepaticojejunostomy (RYHJ) is considered the optimal therapeutic option, with success rates ranging from 75% to 98%. Several series have demonstrated the advancements of the laparoscopic approach for resolving this condition. The objective of this study is to describe our experience in the laparoscopic repair of BDI. METHODS A retrospective, descriptive study was conducted, including patients who underwent laparoscopic repair after BDI. Demographic, clinical, surgical, and postoperative variables were analysed using descriptive statistical analyses. RESULTS Eight patients with BDI underwent laparoscopic repair (out of 81 surgically repaired patients). Women comprised 75% of the sample. A complete laparoscopic repair was achieved in 75% (6) of cases. The mean age was 40.8 ± 16.61 years (range 19-65). Injuries at or above the confluence (Strasberg-Bismuth ≥ E3) occurred in 25% of cases (2). Primary repair was performed in two cases. Half of the cases underwent a Hepp-Couinaud laterolateral RYHJ, while three patients received a terminolateral RYHJ, and one underwent a bi-terminolateral RYH. The mean operative time was 260 min (range 120-360). Overall morbidity was 37.5% (3 cases): two minor complications (bile leak grade A and drainage-related bleeding) and one major complication (bile leak grade C). No mortality was recorded. The maximum follow-up period reached 26 months (range 6-26). CONCLUSIONS Our study demonstrates the feasibility of laparoscopic RYHJ in a selected group of patients, offering the benefits of a minimally invasive approach.
Collapse
Affiliation(s)
- Marcelo Enrique Lenz Virreira
- Unidad de Cirugía Hepatobiliar Compleja, Pancreática y Trasplante Hepático, Hospital de Alta Complejidad en Red "El Cruce", Florencio Varela, Argentina.
| | - Rodrigo Antonio Gasque
- Unidad de Cirugía Hepatobiliar Compleja, Pancreática y Trasplante Hepático, Hospital de Alta Complejidad en Red "El Cruce", Florencio Varela, Argentina
| | - José Gabriel Cervantes
- Unidad de Cirugía Hepatobiliar Compleja, Pancreática y Trasplante Hepático, Hospital de Alta Complejidad en Red "El Cruce", Florencio Varela, Argentina
| | - Lourdes Mollard
- Unidad de Cirugía Hepatobiliar Compleja, Pancreática y Trasplante Hepático, Hospital de Alta Complejidad en Red "El Cruce", Florencio Varela, Argentina
| | - Natalia Soledad Ruiz
- Unidad de Cirugía Hepatobiliar Compleja, Pancreática y Trasplante Hepático, Hospital de Alta Complejidad en Red "El Cruce", Florencio Varela, Argentina
| | - Magalí Chahdi Beltrame
- Unidad de Cirugía Hepatobiliar Compleja, Pancreática y Trasplante Hepático, Hospital de Alta Complejidad en Red "El Cruce", Florencio Varela, Argentina
| | - Francisco Juan Mattera
- Unidad de Cirugía Hepatobiliar Compleja, Pancreática y Trasplante Hepático, Hospital de Alta Complejidad en Red "El Cruce", Florencio Varela, Argentina
| | - Emilio Gastón Quiñonez
- Unidad de Cirugía Hepatobiliar Compleja, Pancreática y Trasplante Hepático, Hospital de Alta Complejidad en Red "El Cruce", Florencio Varela, Argentina
| |
Collapse
|
|
3
|
AYDIN MC, ÖZŞAY O, KARABULUT K. Endoskopik olarak tedavi edilemeyen koledok taşlarında koledokoduodenostomi. Hem geleneksel hem de güncel yöntem. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2022. [DOI: 10.25000/acem.1101714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Amaç: Koledok taşlarının altın standart güncel tedavi yöntemi endoskopik retrograd kolanjiopankreatografi (ERCP) ile taş çıkarılmasıdır. Bunun başarısız olduğu durumlarda alternatif cerrahi tedavi yöntemleri ön plana çıkmaktadır. Geleneksel bir yöntem olan koledokoduodenostomi (CDD) de bunlardan biridir. Biz de ERCP'nin başarısız olduğu hastalardaki konvansiyonel CDD sonuçlarımızı sunmayı amaçladık.
Yöntemler: Mart 2015 ve Şubat 2022 tarihleri arasında ERCP ile tedavi edilemeyen koledok taşı olan ve konvansiyonel koledok eksplorasyonu, taş çıkarılması ve CDD uygulanan 23 hastanın klinikodemografik verileri, perioperatif bulguları ve postoperatif sonuçları retrospektif olarak analiz edildi.
Bulgular: Hastaların median yaşı 71 (41-85) olup, 13’ü (%56) kadındı. Hastaların 5’inde (21%) geçirilmiş kolesistektomi, 7’sinde (30%) gastrektomi + gastroenterostomi ameliyatı öyküsü vardı. En sık başvuru semptomu karın ağrısıydı (39 %). Başarısız ERCP sayısı median 1 (1-6) olup, başarısızlık nedenleri 7 hastada gastroenterostomi olması, 9 hastada impakte taş olması, 6 hastada taş boyutu ve sayısının fazla olması, 1 hastada da papilla açılım anomalisiydi. Hastaların median koledok çapı 15 (10-40) mm'di. Operasyon süresi median 120 (60-240) dk olup, perioperatif komplikasyon gelişmedi. Yatış süresi median 7 (4-14) gündü. Postoperatif erken dönemde 2 (8%) hastada yara yeri enfeksiyonu, 1 (4%) hastada da eviserasyon görüldü. Mortalite izlenmedi. Hastaların ortalama takip süresi median 27 (2-77) aydı ve geç dönemde 2 (8%) hastada insizyonel herni ile karşılaşıldı. Sump sendromuna ait bulgular hiçbir hastamızda gözlenmedi.
Sonuç: ERCP ile çıkarılamayan koledok taşlarının tedavisinde CDD seçilmiş hastalarda efektif ve güvenli bir cerrahi tedavi yöntemidir.
Collapse
|
|
4
|
Attri MR, Bhardwaj R, Kumar IA, Samoon AH, Attri U. Laparoscopic Choledochoduodenostomy in Bile Duct Stone Diseases. Indian J Surg 2021. [DOI: 10.1007/s12262-021-02768-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
|
5
|
Ding H, Raijman I, Kalloo AN. Endoclip papilloplasty for a patulous and incompetent biliary papilla: a therapeutic misadventure. VideoGIE 2019; 4:493. [PMID: 31709339 PMCID: PMC6831898 DOI: 10.1016/j.vgie.2019.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Hui Ding
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Isaac Raijman
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Anthony N Kalloo
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| |
Collapse
|
|
6
|
Hori T, Aisu Y, Yamamoto M, Yasukawa D, Iida T, Yagi S, Taniguchi K, Uemoto S. Laparoscopic approach for choledochojejunostomy. Hepatobiliary Pancreat Dis Int 2019; 18:285-288. [PMID: 31023579 DOI: 10.1016/j.hbpd.2019.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/08/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Tomohide Hori
- Department of Surgery, Shiga General Hospital, Moriyama 524-8524, Japan.
| | - Yuki Aisu
- Department of Digestive Surgery, Tenriyorodusoudanjyo Hospital, Tenri 632-8552, Japan
| | | | - Daiki Yasukawa
- Department of Digestive Surgery, Tenriyorodusoudanjyo Hospital, Tenri 632-8552, Japan
| | - Taku Iida
- Department of Hepato-Biliary-Pancreatic and Surgery and Transplantation, Kyoto University Hospital, Kyoto 606-8507, Japan
| | - Shintaro Yagi
- Department of Hepato-Biliary-Pancreatic and Surgery and Transplantation, Kyoto University Hospital, Kyoto 606-8507, Japan
| | - Kentaro Taniguchi
- First Department of Surgery, Mie University Hospital, Tsu 514-8507, Japan
| | - Shinji Uemoto
- Department of Hepato-Biliary-Pancreatic and Surgery and Transplantation, Kyoto University Hospital, Kyoto 606-8507, Japan
| |
Collapse
|
|
7
|
Hori T. Comprehensive and innovative techniques for laparoscopic choledocholithotomy: A surgical guide to successfully accomplish this advanced manipulation. World J Gastroenterol 2019; 25:1531-1549. [PMID: 30983814 PMCID: PMC6452235 DOI: 10.3748/wjg.v25.i13.1531] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/05/2019] [Accepted: 03/11/2019] [Indexed: 02/06/2023] Open
Abstract
Surgeries for benign diseases of the extrahepatic bile duct (EHBD) are classified as lithotomy (i.e., choledocholithotomy) or diversion (i.e., choledochojejunostomy). Because of technical challenges, laparoscopic approaches for these surgeries have not gained worldwide popularity. The right upper quadrant of the abdomen is advantageous for laparoscopic procedures, and laparoscopic choledochojejunostomy is safe and feasible. Herein, we summarize tips and pitfalls in the actual procedures of choledocholithotomy. Laparoscopic choledocholithotomy with primary closure of the transductal incision and transcystic C-tube drainage has excellent clinical outcomes; however, emergent biliary drainage without endoscopic sphincterotomy and preoperative removal of anesthetic risk factors are required. Elastic suture should never be ligated directly on the cystic duct. Interrupted suture placement is the first choice for hemostasis near the EHBD. To prevent progressive laceration of the EHBD, full-layer interrupted sutures are placed at the upper and lower edges of the transductal incision. Cholangioscopy has only two-way operation; using dedicated forceps to atraumatically grasp the cholangioscope is important for smart maneuvering. The duration of intraoperative stone clearance accounts for most of the operative time. Moreover, dedicated forceps are an important instrument for atraumatic grasping of the cholangioscope. Damage to the cholangioscope requires expensive repair. Laparoscopic approach for choledocholithotomy involves technical difficulties. I hope this document with the visual explanation and literature review will be informative for skillful surgeons.
Collapse
Affiliation(s)
- Tomohide Hori
- Department of Hepato-Biliary-Pancreatic Surgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| |
Collapse
|
|
8
|
Kaushal-Deep SM, Singh V, Mani R, Gupta P, Lodi M. Negotiating the Curve of Laparoscopic Hepatopancreaticobiliary Procedures (Basic to Advanced) at a Tertiary Rural Teaching Institute. Int J Appl Basic Med Res 2019; 8:237-243. [PMID: 30598911 PMCID: PMC6259292 DOI: 10.4103/ijabmr.ijabmr_399_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: We present here our experience of laparoscopic hepatopancreaticobiliary (HPB) surgeries at our rural institute and the hurdles we faced overcoming the various challenges. Aims and Objectives: The objectives of this study were to assess the feasibility, successful completion, operative time, conversions/requirement of assistance, duration of hospital stay, and postoperative complications on the HPB procedures performed laparoscopically in our surgical unit; and to help young surgeons for smooth navigation through their laparoscopic career. Materials and Methods: All the patients admitted under our unit over the past 9 years for elective HPB surgeries operated by a single surgeon were included in this study. Results: Total 1304 basic laparoscopic biliary procedures were successfully completed laparoscopically. After getting well versed with the standard procedure, we switched over to difficult cases involving densely adhered gallbladder, frozen Calot's, Mirizzi's syndrome, use of intraoperative cholangiogram, and take down of cholecystoduodenal fistulas. Next step in evolution was doing laparoscopic common bile duct exploration and biliary procedures with decreased number of ports. Five hundred and sixty-eight procedures were advanced HPB surgeries. With time, we also started performing a variety of complex advanced laparoscopic procedures such as cystogastrostomy, hepaticojejunostomy, choledochoduodenostomy, and pancreaticojejunostomy. All these procedures have been discussed with respect to operative duration, conversion rates, blood loss, hospital stay, and complication rates in the initial and later parts of the learning curves and further compared with previous standard large case studies on specific surgeries. Conclusion: Several hurdles are met in a new institute, that too, a rural one. The present discussion will help the budding surgeons to identify their deficiencies and chart a way forward in a systematic scientific manner.
Collapse
Affiliation(s)
| | - Vikas Singh
- Department of Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
| | - Rudra Mani
- Department of Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
| | - Poonam Gupta
- Department of Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
| | - Mehershree Lodi
- Department of Anesthesia, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| |
Collapse
|
|
9
|
Biliary Bypass with Laparoscopic Choledochoduodenostomy. J Gastrointest Surg 2018; 22:928-933. [PMID: 29340917 DOI: 10.1007/s11605-017-3663-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/18/2017] [Indexed: 01/31/2023]
Abstract
Laparoscopic choledochoduodenostomy (LCDD) is employed to treat many benign biliary diseases when endoscopic or percutaneous techniques are not feasible. We describe our technique for LCDD, which utilizes common bile duct transection and an end-to-side biliary-enteric anastomosis. This procedure includes the following elements: isolation and transection of the common bile duct, mobilization of the duodenum (Kocher maneuver), inspection of the common bile duct, and end-to-side biliary-enteric anastomosis. Key details and pitfalls are discussed. Over a 5-year period, LCDD was performed on 18 patients. Indications included intractable abdominal pain (10) and choledocholithiasis (8). The majority of patients, 83%, tolerated the operation well with no complications. There was one postoperative intra-abdominal abscess and two anastomotic strictures, one in the immediate postoperative period and the other 9 months after the operation. The median length of stay was 4 days (IQR 3.0-5.3), and there was minimal blood loss. Based on our experience, LCDD with transection and end-to-side biliary-enteric anastomosis is a safe and effective biliary bypass technique.
Collapse
|
|
10
|
Cuendis-Velázquez A, Bada-Yllán O, Trejo-Ávila M, Rosales-Castañeda E, Rodríguez-Parra A, Moreno-Ordaz A, Cárdenas-Lailson E, Rojano-Rodríguez M, Sanjuan-Martínez C, Moreno-Portillo M. Robotic-assisted Roux-en-Y hepaticojejunostomy after bile duct injury. Langenbecks Arch Surg 2018; 403:53-59. [PMID: 29374315 DOI: 10.1007/s00423-018-1651-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/10/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND The Da Vinci Robotic Surgical System has positioned itself as a tool that improves the ergonomics of the surgeon, facilitating dissection in confined spaces and enhancing the surgeon's skills. The technical aspects for successful bile duct repair are well-vascularized ducts, tension-free anastomosis, and complete drainage of hepatic segments, and all are achievable with robotic-assisted approach. METHODS This was a retrospective study of our prospectively collected database of patients with iatrogenic bile duct injury who underwent robotic-assisted Roux-en-Y hepaticojejunostomy. Pre-, intra-, and short-term postoperative data were analyzed. RESULTS A total of 30 consecutive patients were included. The median age was 46.5 years and 76.7% were female. Neo-confluences with section of hepatic segment IV were performed in 7 patients (those classified as Strasberg E4). In the remaining 23, a Hepp-Couinaud anastomosis was built. There were no intraoperative complications, the median estimated blood loss was 100 mL, and the median operative time was 245 min. No conversion was needed. The median length of stay was 6 days and the median length of follow-up was 8 months. The overall morbidity rate was 23.3%. Two patients presented hepaticojejunostomy leak. No mortality was registered. CONCLUSION Robotic surgery is feasible and can be safely performed, with acceptable short-term results, in bile duct injury repair providing the advantages of minimally invasive surgery. Further studies with larger number of cases and longer follow-up are needed to establish the role of robotic assisted approaches in the reconstruction of BDI.
Collapse
Affiliation(s)
- Adolfo Cuendis-Velázquez
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico.
| | - Orlando Bada-Yllán
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico
| | - Mario Trejo-Ávila
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico
| | - Enrique Rosales-Castañeda
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico
| | - Andrés Rodríguez-Parra
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico
| | - Alberto Moreno-Ordaz
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico
| | - Eduardo Cárdenas-Lailson
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico
| | - Martin Rojano-Rodríguez
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico
| | - Carlos Sanjuan-Martínez
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico
| | - Mucio Moreno-Portillo
- Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14090, Mexico City, Mexico
| |
Collapse
|
|
11
|
Laparoscopic choledochoduodenostomy as a reliable rescue procedure for complicated bile duct stones. Surg Endosc 2017; 32:1828-1833. [DOI: 10.1007/s00464-017-5868-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 09/04/2017] [Indexed: 02/06/2023]
|
|
12
|
Cuendis-Velázquez A, E. Trejo-Ávila M, Rosales-Castañeda E, Cárdenas-Lailson E, E. Rojano-Rodríguez M, Romero-Loera S, A. Sanjuan-Martínez C, Moreno-Portillo M. Colédoco-duodeno anastomosis laparoscópica. Cir Esp 2017; 95:397-402. [DOI: 10.1016/j.ciresp.2017.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 06/22/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
|
|
13
|
Laparoscopic coledochoduodenostomy for chronic biliary stricture (with video). J Visc Surg 2017; 154:461-462. [PMID: 28728888 DOI: 10.1016/j.jviscsurg.2017.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
|
14
|
Zhang H, Xue F, Zhang J, Liu W, Dong D, Zhu H, Wu R, Lv Y. A novel magnetic device for laparoscopic cholangiojejunostomy. J Surg Res 2017; 218:271-276. [PMID: 28985860 DOI: 10.1016/j.jss.2017.05.094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 04/28/2017] [Accepted: 05/24/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Laparoscopic cholangiojejunostomy (LCJ) with hand-sewn technique is technically difficult and requires a long time to master. The purpose of this study was to assess the feasibility of LCJ using a novel magnetic compression device (MCD) in dogs. METHODS The concept of the purse-string technique of the circular stapler was used to design a novel MCD for LCJ. To test the feasibility of this MCD in a more clinically relevant situation, four dogs were subjected to bile duct ligation. When the diameter of their bile ducts reached 10 mm, LCJ using MCD was performed. The anastomotic time and expelling time of the magnets were assessed. RESULTS In the clinically relevant model of bile duct obstruction in dogs, LCJ created with this MCD yielded patent anastomoses. The LCJ procedure using this novel MCD was simple, and the mean anastomotic time was 12.9 ± 1.73 min. All animals recovered smoothly after the operation without complications. All magnets spontaneously passed through the rectum in 14.5 ± 2.08 d after LCJ. CONCLUSIONS LCJ in dogs using this novel MCD is feasible.
Collapse
Affiliation(s)
- Hongke Zhang
- Institute of Advanced Surgical Technology and Engineering, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Fei Xue
- Institute of Advanced Surgical Technology and Engineering, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Jing Zhang
- Institute of Advanced Surgical Technology and Engineering, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Wenyan Liu
- Institute of Advanced Surgical Technology and Engineering, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Dinghui Dong
- Institute of Advanced Surgical Technology and Engineering, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Haoyang Zhu
- Institute of Advanced Surgical Technology and Engineering, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Rongqian Wu
- Institute of Advanced Surgical Technology and Engineering, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Yi Lv
- Institute of Advanced Surgical Technology and Engineering, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China.
| |
Collapse
|
|
15
|
Priego P, Escrig J, Ángel V, Villegas C, Salvador JL. Laparoscopic Choledochoduodenostomy: An Option in Cases of Obstructive Biliary Tract. Am Surg 2015. [DOI: 10.1177/000313481508100504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Pablo Priego
- Division of Upper Gastrointestinal and Hepatobiliopancreatic Surgery, Department of General Surgery, Hospital Universitario General Castellón, Spain
| | - Javier Escrig
- Division of Upper Gastrointestinal and Hepatobiliopancreatic Surgery, Department of General Surgery, Hospital Universitario General Castellón, Spain
| | - Vicente Ángel
- Division of Upper Gastrointestinal and Hepatobiliopancreatic Surgery, Department of General Surgery, Hospital Universitario General Castellón, Spain
| | - Carmen Villegas
- Division of Upper Gastrointestinal and Hepatobiliopancreatic Surgery, Department of General Surgery, Hospital Universitario General Castellón, Spain
| | - José Luis Salvador
- Division of Upper Gastrointestinal and Hepatobiliopancreatic Surgery, Department of General Surgery, Hospital Universitario General Castellón, Spain
| |
Collapse
|
|
16
|
Lee JS, Hong TH. Laparoscopic choledochojejunostomy in various hepatobiliary and pancreatic surgeries: a single surgeon's experience. J Laparoendosc Adv Surg Tech A 2015; 25:305-10. [PMID: 25768335 DOI: 10.1089/lap.2014.0539] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The aims of this study were to measure the learning curve for laparoscopic choledochojejunostomy (LCJ), to describe the technical tips and to report the follow-up data. MATERIALS AND METHODS The results of LCJ performed on 84 patients were analyzed. Patients were divided into eight groups, by surgical order. The plateau of the learning curve was defined as the period during which the operative time showed a dramatic decrease. The exact operative time was recorded using video analysis. RESULTS Compared with the first three groups, the fourth group showed a significantly shorter LCJ time. The subsequent groups showed a plateau, indicating that there were no more significant changes in the LCJ time. After the plateau of the learning curve was reached, the average LCJ time was 27.4±4.7 minutes. Six cases of postoperative bile leakage occurred, with all occurring before the plateau of the learning curve was reached. Five of the 6 cases of bile leakage had a nondilated common bile duct. CONCLUSIONS Even for a surgeon experienced in laparoscopic surgery, there is a steep learning curve for the performance of LCJ. With careful video review, education of the surgical team, and various technical tips, the learning curve can be shortened. After the learning curve, experienced surgeons can perform LCJ with acceptable results.
Collapse
Affiliation(s)
- Jun Suh Lee
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | | |
Collapse
|
|
17
|
Qin M, Zou F, Zhao H, Ding G. Minimally invasive phasic treatment protocol for the treatment of extrahepatic bile duct stones. J Laparoendosc Adv Surg Tech A 2012; 22:797-801. [PMID: 23039703 DOI: 10.1089/lap.2012.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To identify the optimal treatment for extrahepatic bile duct stones using endoscopy, laparoscopy, and the combination of the two in different conditions and to develop phasic treatment protocols for their minimally invasive treatment. PATIENTS AND METHODS Of 2718 cases of extrahepatic bile duct stones collected from June 2005 to December 2011, 50 were randomly selected to receive open bile duct exploration and T-tube drainage, serving as the control group. For the rest, a one-scope protocol, two-scope protocol (two-scope protocol A or two-scope protocol B), or three-scope protocol was adopted according to the specific conditions of stones and the endoscopic treatment results. The treatment outcomes and postoperative clinical indicators of the minimally invasive treatment protocols were analyzed and compared with those of the control group. RESULTS Among the 2668 cases of extrahepatic bile duct stones receiving the phasic minimally invasive treatment, the treatment success rate was 97.79%, and there were no severe postoperative complications. Compared with the control group, the minimally invasive treatment protocols had higher success rates, less trauma, and significantly shortened hospital stays. CONCLUSIONS The protocols were applied step by step based on the different types and levels of extrahepatic bile duct stones, fully embodying the advantages of the combined minimally invasive treatment of endoscopy and laparoscopy, thus expanding the scope of minimally invasive surgical treatment for extrahepatic bile duct stones and improving treatment success rate.
Collapse
Affiliation(s)
- Mingfang Qin
- Minimally Invasive Surgery Center of Tianjin Nankai Hospital, 122 Sanwei Rd., Nankai, Tianjin, China
| | | | | | | |
Collapse
|