General Surgery Resident, Stony Brook Medicine, Stony Brook, NY.
Surgery, Chief Bariatric, Foregut and Advanced GI Surgery, Vice Chair for Clinical Affairs, Stony Brook University.
Surg Laparosc Endosc Percutan Tech. 2022 Oct 1;32(5):616-620. doi: 10.1097/SLE.0000000000001079.
BACKGROUND: Biliary disease is common occurrence and can make up a large portion of the practice of a general surgeon. Choledocholithasis is a common entity amongst those with biliary disease. Although modern trends favor endoscopic retrograde cholangiopancreatography (ERCP) and other imaging modalities for the diagnosis and management of choledocholithiasis, laparoscopic common bile duct exploration (LCBDE) is likely underutilized. METHODS: A literature summary utilizing a PUBMED search was performed to provide an up-to-date account regarding the latest data on LCBDE. A video identifying and explaining the critical components of a LBCDE procedure is provided. RESULTS: LCBDE is an underutilized procedure which offers equivalent clinical outcomes compared with ERCP along with a shorter length of stay and reduced costs. LCBDE is also noted to be an effective option for common bile duct stones in the setting of altered anatomy, such as a Roux-en-Y gastric bypass. CONCLUSION: Although modern trends favor ERCP and other imaging modalities for the diagnosis and management of choledocholithiasis, LCBDE is likely underutilized by surgeons. LCBDE can provide many benefits to patients including avoidance of additional procedures, shorter length of stay, higher success rates, and less costs. Out video should act is a guide for those surgeons interested in implementation LCBDE in their practice.
背景:胆道疾病较为常见,可能构成普通外科医生实践的很大一部分。胆石症是胆道疾病中常见的一种。尽管现代趋势倾向于使用内镜逆行胰胆管造影(ERCP)和其他成像方式来诊断和治疗胆总管结石,但腹腔镜胆总管探查术(LCBDE)可能未得到充分利用。
方法:使用 PUBMED 搜索进行文献总结,提供关于 LCBDE 最新数据的最新信息。提供了一段视频,用于识别和解释 LCBDE 手术的关键步骤。
结果:LCBDE 是一种未充分利用的手术,与 ERCP 相比具有同等的临床效果,同时住院时间更短,成本更低。LCBDE 还被认为是 Roux-en-Y 胃旁路等解剖结构改变时治疗胆总管结石的有效选择。
结论:尽管现代趋势倾向于使用 ERCP 和其他成像方式来诊断和治疗胆总管结石,但外科医生可能未充分利用 LCBDE。LCBDE 可以为患者带来许多好处,包括避免额外的手术、缩短住院时间、更高的成功率和更低的成本。我们的视频应该为那些有兴趣在实践中实施 LCBDE 的外科医生提供指导。
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