Laparoscopic common bile duct exploration after unsuccessful endoscopic stone removal.

BACKGROUND

When common bile duct (CBD) stone removal by endoscopy fails, stone removal is a mandatory procedure for the surgeon. However, it is unclear that the laparoscopic procedure is the alternative treatment in this setting. The purpose of this study is to investigate the result of laparoscopic CBD exploration (LCBDE) following unsuccessful CBD stone removal by endoscopy.

SUBJECTS AND METHODS

This study is a retrospective analysis of 82 consecutive LCBDEs. Group 1 included patients who underwent secondary LCBDE after stone removal by endoscopic retrograde cholangiopancreatography (ERCP) failed. Group 2 was defined when primary LCBDE was performed without ERCP. Perioperative outcomes were compared between the two groups.

RESULTS

There were 44 patients in Group 1 and 38 patients in Group 2. There were no significant differences in demographics. Stone clearance was nearly complete in both groups. There was no significant difference between the two groups for operative time, hospital days, open conversion rate, recurrence rate, or complications.

CONCLUSIONS

LCBDE is an acceptable alternative treatment when endoscopic CBD stone removal is impossible or incomplete.