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Laparoscopic Common Bile Duct Exploration in Cirrhotic Patients With Choledocholithiasis

Qiu, Jianguo MD*; Yuan, Haichao MD; Chen, Shuting MD*; Wu, Hong MD, PhD*

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: February 2015 - Volume 25 - Issue 1 - p 64–68
doi: 10.1097/SLE.0000000000000018
Original Articles
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Background: Although laparoscopic common bile duct exploration (LCBDE) has become the standard procedure for most choledocholithiasis patients, the application of this procedure to liver cirrhosis is still in debate. The aim of current study was to evaluate the feasibility and safety of LCBDE in choledocholithiasis patients with compensated liver cirrhosis.

Materials and Methods: From January 2006 to December 2012, 346 LCBDE performed in our hospital. According to previous defined liver condition, the patients were divided into group A (liver cirrhosis, n=132) and group B (without cirrhosis, n=214). The perioperative data for the 2 groups were retrospectively reviewed and compared.

Results: LCBDE was successfully completed in 326 patients. Conversion from laparoscopic to open surgery was necessary for 20 patients (5.7%) mainly because of hemorrhage (5, 25%) and severe adhesions (8, 40%); a T-tube was placed in 211 patients (64.7%), and primary closure was done in 115 (35.3%). There was significant difference for groups A and B in term of intraoperative blood loss (85 vs. 35 mL; P<0.01). However, the 2 groups showed no significant differences with respect to mean operation time (2.1 vs. 1.9 h; P=0.07), complication rates (10.6% vs. 8.8%; P=0.6), and mean hospital stay (4.2 vs. 4.0 d; P=0.6), conversion rate (5.3% vs. 6.1%; P=0.77), and retained choledocholithiasis rate (8.3% vs. 7.1%; P=0.65). There was no mortality in both the groups.

Conclusion: LCBDE is a feasible, effective, and safe surgical procedure for choledocholithiasis patients with compensated cirrhosis.

Departments of *Hepatobiliary Pancreatic Surgery

Urology Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

Supported by Science and Technology Support Project of Sichuan Province (2009FC0093).

The authors declare no conflicts of interest.

Reprints: Hong Wu, MD, PhD, Department of Hepatobiliary Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China (e-mail: wuhongjoy@163.com).

Received May 26, 2013

Accepted September 30, 2013

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