The Transcystic approach

2021 ◽  
Author(s):  
Alberto Martinez-Isla ◽  
Lalin Navaratne
Keyword(s):  
Transcystic Approach

scholarly journals Abordaje laparoscópico sistemático de la coledocolitiasis

2021 ◽  
Vol 113 (1) ◽  
pp. 62-72
Author(s):  
Carlos M. Canullán ◽  
◽  
Enrique J. Petracchi ◽  
Nicolás Baglietto ◽  
Hugo I. Zandalazini ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Preoperative Diagnosis ◽  
Length Of Hospital Stay ◽  
Common Bile Duct Stones ◽  
Single Stage ◽  
Bile Duct Stones ◽  
Bile Duct Injuries ◽  
Transcystic Approach

Background: The prevalence of common bile duct stones associated with cholelithiasis increases with age and is about 15 % in the 8th decade of life but its management is still controversial. Some surgeons prefer the single-stage approach with laparoscopy while others suggest the two-stage management with preoperative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy. Objective: The aim of the present study was to evaluate the efficacy of feasibility of single-stage laparoscopic surgery in patients with cholelithiasis and choledocholithiasis. Material and methods: We conducted a retrospective study with prospectively collected data between July 2008 and July 2018. Results: Of 2447 laparoscopic cholecystectomies performed during the study period, 416 presented common bile duct stones. The global success of the transcystic approach to clear common bile duct stones was 81.2%, 70.4% in the cases with preoperative diagnosis of choledocholithiasis and 92.9% for other diagnoses. The rate of complications was 4% without deaths or bile duct injuries. Conclusion: Single-stage laparoscopic surgery is an efficient and safe approach based on the high global success of transcystic exploration. The preoperative diagnosis of choledocholithiasis reduces the efficacy of the procedure due to greater indication of choledocotomy, with complications and longer length of hospital stay.

Laparoscopic management of common bile duct stones: transcystic approach and choledochotomy

2002 ◽  
Vol 9 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Hiromi Tokumura ◽  
Akiko Umezawa ◽  
Hui Cao ◽  
Nobuhide Sakamoto ◽  
Yoichi Imaoka ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Laparoscopic Management ◽  
Transcystic Approach

PERCUTANEOUS MANAGEMENT OF A BLADDER-DRAINED PANCREAS TRANSPLANT PSEUDOCYST BY A TRANSCYSTIC APPROACH

1997 ◽  
Vol 64 (11) ◽  
pp. 1568-1571 ◽  
Author(s):  
Richard Shlansky-Goldberg ◽  
Constantin Cope ◽  
James McGuckin ◽  
Jill Jacobs ◽  
Jane Sohn ◽  
...  
Keyword(s):  
Pancreas Transplant ◽  
Transcystic Approach

scholarly journals Dilatation of the Cystic Duct Confluence in Laparoscopic Common Bile Duct Exploration and stone extraction for Patients with Secondary Choledocholithiasis

2019 ◽  
Author(s):  
Xiao-Bin Yang ◽  
An-Shu Xu ◽  
Jian-Gang Li ◽  
Yong-Ping Xu ◽  
De-Song Xu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Duct ◽  
Common Bile Duct Exploration ◽  
Stone Extraction ◽  
Non Invasive ◽  
Transcystic Approach ◽  
Surgical Modality ◽  
Cbd Exploration

Abstract The advent of endoscopic and laporoscopic techniques changed surgery in many regards. A number of options exist in the management of cholelithiasis and secondary choledocholithiasis. Among them, laparoscopic common bile duct (CBD) exploration with the choledocotomy followed by laparoscopic cholecystectomy (LC) has gained popularity. However, efforts should be made for minimally invasive or non-invasive to the CBD. For this purpose, we modified the surgical modality by laparoscopic transcystic approach with dilatation of the cystic duct confluence in CBD exploration (LTD-CBDE). The aim of this work was to assess the feasibility, safety and effectivity of LTD-CBDE based on our preliminary experience.

scholarly journals The role of choledochoscopy in transductal laparoscopic common bile duct exploration

2021 ◽  
Author(s):  
K. Atstupens ◽  
H. Plaudis ◽  
E. Saukane ◽  
A. Rudzats
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Exploration ◽  
Complication Rates ◽  
Time Saving ◽  
Patient Demographics ◽  
Operative Outcomes ◽  
Additional Equipment ◽  
Transcystic Approach ◽  
A Prospective Study

Laparoscopic common bile duct exploration (LCBDE) performed by choledochoscope through the cystic duct or directly through the incision in the common bile duct (CBD) are well established methods for restoring biliary drainage function in patients with choledocholithiasis. Although it plays a crucial role in the transcystic approach, transductal approach can be achieved differently. However, it has restrictions in availability due to its expensiveness. Objective — to report efficacy of transductal LCBDE without laparoscopic choledochoscopy. Materials and methods. This is a prospective study of urgently admitted patients who underwent trans‑ductal LCBDE due to confirmed choledocholithiasis. During laparoscopy, clearance of the CBD was achieved in two ways: by choledochoscopy (group CS+, n = 43) and without it (group CS–, n = 34). The data of patient demographics, comorbidities, operative outcomes, morbidity, mortality and long‑term biliary complications were analysed and compared between the groups. Results. Out of a total of 154 patients with confirmed choledocholithiasis, the trans‑ductal approach of LCBDE was applied to 77 patients. In 43 patients, clearance was done with choledochoscope (group CS+) and in 34 patients without it (group CS–). Gallstone related complications and comorbidities did not differ between the groups. Surgery was done 4 days after admission in both groups. Median duration of the operation was significantly shorter in the group CS–, 93 vs 120 minutes (p = 0.036), without any difference in conversion and complication rates. Clearance rate was markedly high in both groups. Conclusions. Transductal laparoscopic common bile duct exploration without choledochoscopy is a time‑saving, safe and effective way for CBD clearance, without additional equipment.  

scholarly journals P-BN59 Danger is there, do we want to know about it? Routine intra operative cholangiography highlights dangerous biliary anatomy for safer cholecystectomy

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Noor Ul ain ◽  
Saira Bibi ◽  
Ian Tait ◽  
Samer Zino
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Cystic Duct ◽  
Filling Defect ◽  
Single Session ◽  
Biliary Anatomy ◽  
Operative Cholangiography ◽  
Transcystic Approach ◽  
Contrast Flow

Abstract Background Normal biliary anatomy is uncommon. Different classification for biliary anatomy has been described, with Huang Types A4 & A5 of great interest for laparoscopic cholecystectomy (LC) due to the proximity of aberrant bile duct to Cystic duct (CD). These types of dangerous anatomy might contribute to bile duct injury. This study aims to analyse the prevalence of dangerous biliary anatomy. Methods Prospectively collected data for all patients who underwent laparoscopic cholecystectomy was analysed. All LC were performed by single surgeon or under  his direct supervision, between 01/07/2020 and 20/08/2021. Index admission and single session management of cholelithiasis disease with routine Laparoscopic cholecystectomy + intra operative cholangiography (IOC) +/- LCBD exploration were standard practice. Results Laparoscopic cholecystectomy was performed in 137 patients. Mean age was 56y (17-84).  62% were females.   66% of Laparoscopic cholecystectomies were emergency. IOC was performed in 92% of cases. Abnormal biliary anatomy was found in 54% : Huang A1 - 48%, A2 - 29%, A3 - 12%, A4 - 9.7% and A5 - 0.7%. Dangerous anatomy (A4 and A5) was found in 10.5%, 78 % were females.  Female with dangerous anatomy were younger than males 49 y, 60y respectively. Nassar difficulty grading for dangerous anatomy was as follows: G2 28%, G3 42% and G3 28% Abnormal cholangiogram was found in 48%, due to filling defect in 58%, no contrast flow into duodenum in 4%, Cystic duct stone in 4%, and short CD in 8%. CBD stones were treated using transcystic approach in 92% of cases. No intra-operative or post operative complications were recorded for patients with dangerous anatomy.  Conclusions This study demonstrates that dangerous biliary anatomy, that could lead to bile duct injury is relatively common, occurring in 10.7% of LCs. Routine intra-operative cholangiography highlights these high-risk variations in biliary anatomy and may prevent inadvertent bile duct injury in such cases.

scholarly journals Dilatation of the Cystic Duct Confluence in Laparoscopic Common Bile Duct Exploration and stone extraction for Patients with Secondary Choledocholithiasis

2020 ◽  
Author(s):  
Xiao-Bin Yang ◽  
An-Shu Xu ◽  
Jian-Gang Li ◽  
Yong-Ping Xu ◽  
De-Song Xu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Duct ◽  
Common Bile Duct Exploration ◽  
Stone Extraction ◽  
Non Invasive ◽  
Transcystic Approach ◽  
Surgical Modality ◽  
Cbd Exploration

Abstract The advent of endoscopic and laporoscopic techniques changed surgery in many regards. A number of options exist in the management of cholelithiasis and secondary choledocholithiasis. Among them, laparoscopic common bile duct (CBD) exploration with the choledocotomy followed by laparoscopic cholecystectomy (LC) has gained popularity. However, efforts should be made for minimally invasive or non-invasive to the CBD. For this purpose, we modified the surgical modality by laparoscopic transcystic approach with dilatation of the cystic duct confluence in CBD exploration (LTD-CBDE). The aim of this work was to assess the feasibility, safety and effectivity of LTD-CBDE based on our preliminary experience.

Transcystic Approach with Micro-incision of the Cystic Duct and Its Confluence Part in Laparoscopic Common Bile Duct Exploration

2013 ◽  
Vol 23 (12) ◽  
pp. 977-981 ◽  
Author(s):  
Xue-Min Chen ◽  
Yue Zhang ◽  
Hui-Hua Cai ◽  
Dong-Lin Sun ◽  
Sheng-Yong Liu ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Duct ◽  
Common Bile Duct Exploration ◽  
Transcystic Approach

scholarly journals Dilatation of the Cystic Duct Confluence in Laparoscopic Common Bile Duct Exploration and stone extraction for Patients with Secondary Choledocholithiasis

2020 ◽  
Author(s):  
Xiao-Bin Yang ◽  
An-Shu Xu ◽  
Jian-Gang Li ◽  
Yong-Ping Xu ◽  
De-Song Xu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Duct ◽  
Common Bile Duct Exploration ◽  
Stone Extraction ◽  
Non Invasive ◽  
Transcystic Approach ◽  
Surgical Modality ◽  
Cbd Exploration

Abstract The advent of endoscopic and laporoscopic techniques changed surgery in many regards. A number of options exist in the management of cholelithiasis and secondary choledocholithiasis. Among them, laparoscopic common bile duct (CBD) exploration with the choledocotomy followed by laparoscopic cholecystectomy (LC) has gained popularity. However, efforts should be made for minimally invasive or non-invasive to the CBD. For this purpose, we modified the surgical modality by laparoscopic transcystic approach with dilatation of the cystic duct confluence in CBD exploration (LTD-CBDE). The aim of this work was to assess the feasibility, safety and effectivity of LTD-CBDE based on our preliminary experience.

Percutaneous Management of a Bladder-Drained Pancreas Transplant Pseudocyst by a Transcystic Approach

1998 ◽  
pp. 2249
Author(s):  
R. Shlansky-Goldberg ◽  
C. Cope ◽  
J. McGuckin ◽  
J. Jacobs ◽  
J. Sohn ◽  
...  
Keyword(s):  
Pancreas Transplant ◽  
Transcystic Approach
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