Impact of choledochotomy techniques during laparoscopic CBD exploration on short- and long-term clinical outcomes: Time to change concepts (a retrospective cohort study).

Background: complications after laparoscopic common bile duct exploration (LCBDE) regarding choledochotomy techniques have not been adequately studied in the literature. Therefore, this study aimed to retrospectively analyze and compare the impact of choledochotomy techniques during LCBDE among pati...

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Publicado en:International Journal of Surgery Vol. 83; pp. 102 - 107
Autores principales: Ahmed, Emad Ali, Redwan, Alaa Ahmed
Formato: research tables/charts Journal Article
Publicado: Wolters Kluwer Health Nov2020
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: International Journal of Surgery
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      dt: Nov2020
      vid: 83
      pid: 79357
      pub: Wolters Kluwer Health
      place: New York, New York
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        147118687
        147118687
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        147118687
        10.1016/j.ijsu.2020.08.043
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        147118687
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        atl: Impact of choledochotomy techniques during laparoscopic CBD exploration on short- and long-term clinical outcomes: Time to change concepts (a retrospective cohort study).
      aug:
        au:
          Ahmed, Emad Ali
          Redwan, Alaa Ahmed
        affil: Department of General Surgery, Faculty of Medicine, Sohag University, Sohag, 82524, Egypt
      sug:
        subj:
          Cholelithiasis Surgery
          Laparoscopy Methods
          Bile Ducts Surgery
          Biliary Tract Surgical Procedures Methods
          Postoperative Complications Etiology
          Middle Age
          Female
          Male
          Aged
          Adult
          Biliary Tract Surgical Procedures Adverse Effects
          Retrospective Design
          Human
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
          Female
          Male
      ab: Background: complications after laparoscopic common bile duct exploration (LCBDE) regarding choledochotomy techniques have not been adequately studied in the literature. Therefore, this study aimed to retrospectively analyze and compare the impact of choledochotomy techniques during LCBDE among patients with choledocholithiasis during the early and late postoperative periods.Methods: From March 2014 to February 2018, 85 patients with choledocholithiasis (52 females and 33 males) were enrolled in this study. These patients were treated by LCBDE using various choledochotomy techniques, including scalpel or scissor (28 patients, 33%) in group I, diathermy hook (35 patients, 41%) in group II, or an ultrasonic device (22 patients, 26%) in group III. Postoperative follow-up was done for assessment of all possible complications, either early (within the first six months postoperatively) or late (2-6 years postoperatively), with meticulous observation and study of any relevant postoperative events.Results: No statistical difference was detected among the three groups regarding the short- and long-term clinical outcomes, including biliary fistula, biliary stricture, cholangitis, recurrent stones, peritoneal sepsis, wound sepsis, or wound dehiscence.Conclusion: The long-lasting concepts of avoidance of using energy machines such as diathermy and ultrasonic devices with biliary structures should be changed. However, a statistical type I error cannot be excluded because of the small sample size. Therefore, further analysis of prospective randomized studies with a larger number of participants is strongly recommended.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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