A review of general surgery resident experience in common bile duct exploration in the ERCP era
Publication date: Available online 16 February 2020Source: The American Journal of SurgeryAuthor(s): Rachel L. Warner, K. Conley Coleman, Kelsey A. Musgrove, James M. Bardes, David C. Borgstrom, Daniel J. GraboAbstractBackgroundUse of minimally invasive techniques for management of common bile duct (CBD) stones has led to declining number of CBD explorations (CBDE) performed at teaching and non-teaching institutions. We evaluate the impact of this decline on surgery training in bile duct procedures.Study designNational operative data for general surgery residents (GSR) were examined from 2000 to 2018. Biliary operations including, cholecystectomy open and laparoscopic, and CBDE open and laparoscopic were evaluated for mean number of cases per graduating GSR.ResultsDespite increases in number of GSR, case numbers for laparoscopic cholecystectomy increased 39% from 84 to 117, p
ConclusionsPerforming laparoscopic cholecystectomy during admission for acute gallstone cholangitis patients following endoscopic clearance of the bile duct significantly reduced the 30-day readmission rate without affecting the length of stay.
ConclusionThis study found that laparoscopic bile duct exploration can effectively and safely treat bile duct stones suspected at cholecystectomy.
Authors: Vaccari S, Cervellera M, Lauro A, Palazzini G, Cirocchi R, Gjata A, Dibra A, Ussia A, Brighi E, Isaj E, Agastra E, Casella G, Di Matteo FM, Santoro A, Falvo L, Tarroni D, D'andrea V, Tonini V Abstract BACKGROUND: Laparoscopic cholecystectomy represents the gold standard technique for the treatment of lithiasic gallbladder disease. Although it has many advantages, laparoscopic cholecystectomy is not risk-free and in special situations there is a need for conversion into an open procedure, in order to minimize postoperative complications and to complete the procedure safely. The aim of this study is to ident...
Authors: Rerknimitr R, Pham KC Abstract In high-risk surgical patients with acute cholecystitis who are not candidates for early laparoscopic cholecystectomy, gallbladder (GB) drainage is an alternative treatment option. Percutaneous transhepatic gallbladder drainage (PTGBD) is a recommended first line intervention because of its high efficacy and feasibility in most centers. However, with the advent of endoscopic accessories and technology, endoscopic GB drainage has been chosen as a more favorable choice by endoscopists. Endoscopic transpapillary gallbladder drainage (ETGBD) can be performed under either fluorosc...
ConclusionLaparoscopic cholecystectomies in higher risk populations are safe. Alternative methods such as cholecystostomy and ERCP may be of benefit in these patients.
Conditions: Choledocholithiasis With Cholecystitis With Obstruction; Choledocholithiasis With Acute and Chronic Cholecystitis; Cholelithiasis With Acute and Chronic Cholecystitis Interventions: Procedure: ERCP+LC; Procedure: OC+CBD Sponsor: Lumbini Medical College Completed