Single-stage management of choledocholithiasis: intraoperative ERCP versus laparoscopic common bile duct exploration

AbstractBackgroundLaparoscopic cholecystectomy (LC) is the criterion standard for treating patients with symptomatic gallstone disease; however, the optimal technique for extracting common bile duct stones remains unclear. Recent studies have noted improved outcomes with single-stage techniques, such as intraoperative endoscopic retrograde cholangiopancreatography (iERCP) and laparoscopic common bile duct exploration (LCBDE); however only few studies have directly compared those two single-stage techniques.ObjectivesUsing the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database, we retrospectively analyzed the postoperative outcomes of all patients who underwent single-stage LC for choledocholithiasis from 2005 to 2017. UsingCurrent Procedural Terminology (CPT) codes, as well asInternational Classification of Diseases, Ninth Revision (ICD-9) and10th Revision (ICD-10) codes, we stratified patients into two cohorts: those who underwent iERCP and LCBDE. Applying univariate techniques, we evaluated baseline characteristics and postoperative outcomes for both cohorts. Our primary outcomes of interest were 30-day morbidity and 30-day mortality; our secondary outcomes included rates of reoperation, readmission, operative time, and hospital length of stay.ResultsOf the 1814 single-stage LC patients during our 13-year study period, 1185 (65.3%) underwent LCBDE; 629 (34.6%) underwent iERCP. Our univariate analysis showed that the two cohorts w...
Source: Surgical Endoscopy - Category: Surgery Source Type: research

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This study was designed to investigate characteristics of the disease to predict recurrence.Methods: We retrospectively analyzed 617 patients that experienced a first AP attack between January 2009 and December 2014. Based on reviews of clinical and follow-up data, we attempted to identify risk factors of recurrence using Cox regression analysis.Results: During a median follow-up of 3.2 years (range 3-72 months), 100(16.2%) of the 617 study subjects experienced one or more episodes of recurrent acute pancreatitis (RAP). Of these 100 patients, 75(75%) experienced one relapse, 12(12%) two relapses, and 13(13%) ...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Authors: Spętana J, Lipiński A, Jeleń M Abstract Interstitial cells of Cajal (ICC) were first described by Santiago Ramon y Cajal over 100 years ago. They are thought to play an important role in the regulation of gastrointestinal motility. There is increasing evidence that the decline in their number in the gallbladder wall contributes to the formation of concrements. The aim of the study was to determine the exact location of interstitial cells of Cajal in the gallbladder wall in patients with calculous and non-calculous cholecystitis. ...
Source: Polish Journal of Pathology - Category: Pathology Tags: Pol J Pathol Source Type: research
Publication date: Available online 9 December 2019Source: Cirugía Española (English Edition)Author(s): Tania Diaz Antonio, Guadalupe Dolores Garrido Ruiz, Irene Mirón Fernández, Laura Peñuela Ruiz
Source: Cirugia Espanola - Category: Surgery Source Type: research
The cholesterol gallstones diseases (CGD) is highly correlated with metabolic syndrome and type 2 diabetes. The present study aimed to investigate preventive effects of pioglitazone (PIO), an antidiabetic drug...
Source: Lipids in Health and Disease - Category: Lipidology Authors: Tags: Research Source Type: research
ConclusionsCharacterization of GS indicates that different types of stones have different characteristics in terms of microstructure, elemental composition, and distribution. Serum hepatic function test profiles showed an association with the compositions of GS.
Source: Indian Journal of Gastroenterology - Category: Gastroenterology Source Type: research
Condition:   Sphincter of Oddi Function Intervention:   Procedure: Endoclip papillaplasty Sponsor:   Peking University Third Hospital Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Exp Clin Endocrinol Diabetes DOI: 10.1055/a-1033-7273Cholesterol gallstone disease (CGD) affects 10–15% of the adult population worldwide and the prevalence increases as a result of longer life expectancy as well as rising obesity in the general population. Beside well established CGD risk factors including environmental and genetic determinants (LITH genes), a correlation between thyroid dysfunction and CGD has been suggested in several human and murine studies. Although the precise underlying mechanisms are poorly understood, thyroid hormones may impact bile flow, bile compositio...
Source: Experimental and Clinical Endocrinology and Diabetes - Category: Endocrinology Authors: Tags: Mini-Review Source Type: research
Conclusions: Study with 92% of follow-up late after SG demonstrated a 43% development of gallstones: half earlier and half late after surgery. We emphasize the need for late control to detect the real appearance of gallstones after SG.
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research
DR ELLIE CANNON: Frustratingly, gallstones are associated with being overweight, so many sufferers may already be in the process of attempting to lose a few pounds.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Image of the Month Source Type: research
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