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Laparoscopic choledochoduodenostomy

An effective drainage procedure for recurrent pyogenic cholangitis

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Abstract

Background: This article reports the technical aspects of laparoscopic choledochoduodenostomy (LCD) in patients with recurrent pyogenic cholangitis (RPC) and the perioperative results are also evaluated. This is a retrospective review of a prospectively maintained database. Methods: Twelve patients diagnosed to have RPC with the absence of intrahepatic stricture were selected for LCD during the period from 1995 to 2002. The majority of our patients had repeated attacks of cholangitis and had already undergone multiple sessions of endoscopic and operative lithotripsy. The LCD was performed using a five-port approach with the patient lying in the supine position. The stones were first cleared through the longitudinal supraduodenal choledochotomy followed by construction of a side-to-side diamond-shaped anastomosis of at least 15 mm between the bile duct and the first part of the duodenum using 2/0 monocryl in the single-layer method. Results: During the period from 1995 to 2002, 12 patients with RPC underwent LCD. There were 3 male and 9 female patients with a mean age of 62 (40–77). The median operation time was 137.5 min (90–270) and the median postoperative stay was 7.5 days (5–20). All cases were successful using the laparoscopic approach. Average analgesic requirement post operation was 126 mg (50–200 mg) intramuscular pethidine. There was one postoperative bile leak, and this complication was settled by conservative measures. Upon a mean follow-up of 37.6 months (6–91), there was no recurrent attack of cholangitis or any evidence of sump syndrome in this group of patients. Conclusion: LCD is a safe and effective drainage procedure for patients with RPC. Complications are uncommon and postoperative results are promising.

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References

  1. GA Degenshein (1974) ArticleTitleCholedochoduodenostomy: a 18 year study of 175 consecutive cases. Surgery 76 319–324 Occurrence Handle4602098

    PubMed  Google Scholar 

  2. ST Fan TK Choi FL Chan EC Lai J Wong (1990) ArticleTitleRole of computed tomography in the management of recurrent pyogenic cholangitis. Aust NZ J Surg 60 559–605

    Google Scholar 

  3. ST Fan ECS Lai J Wong (1993) ArticleTitleHepatic resection for hepatolithiasis. Arch Surg 128 1070–1074 Occurrence Handle1:STN:280:ByyA2sflsVY%3D Occurrence Handle8368927

    CAS  PubMed  Google Scholar 

  4. ST Fan F Mok SS Zheng ECS Lai CM Lo J Wong (1993) ArticleTitleAppraisal of hepaticocutaneous jejunostomy in the management of hepatolithiasis. Am J Surg 165 332–335 Occurrence Handle1:STN:280:ByyC1M7ivVE%3D Occurrence Handle8447537

    CAS  PubMed  Google Scholar 

  5. ME Franklin JE Balli (1997) ArticleTitleLaparoscopic common bile duct bypass procedures. Semin Laparosc Surg 4 48–53 Occurrence Handle10401139

    PubMed  Google Scholar 

  6. ME Franklin D Pharand D Rosenthal (1994) ArticleTitleLaparoscopic common bile duct exploration. Surg Laparosc Endosc 14 119–124

    Google Scholar 

  7. AT Gurbuz D Watson M Fenoglio (1999) ArticleTitleLaparoscopic choledochoduodenostomy. Am Surg 65 212–214 Occurrence Handle1:STN:280:DyaK1M7ntlKitw%3D%3D Occurrence Handle10075293

    CAS  PubMed  Google Scholar 

  8. AL Hurwitz GA Degenshein (1964) ArticleTitleThe role of choledochoduodenostomy in common duct surgery, reappraisal. Surgery 56 1147–1150 Occurrence Handle1:STN:280:CCqD2c3nvFU%3D

    CAS  Google Scholar 

  9. ECS Lai FPT Mok ES Tan CM Lo ST Fan KT You J Wong (1992) ArticleTitleEndoscopic biliary drainage for severe acute cholangitis. N Engl J Med 326 1582–1586 Occurrence Handle1:STN:280:By2B287mslM%3D Occurrence Handle1584258

    CAS  PubMed  Google Scholar 

  10. SK Lam KP Wong PK Chan H Ngan GB Ong (1978) ArticleTitleRecurrent pyogenic cholangitis: a study by endoscopic retrograde cholangiography. Gastroenterology 74 1196–1203

    Google Scholar 

  11. JL Madden (1978) ArticleTitlePrimary common bile duct stones. World J Surg 2 465–471 Occurrence Handle1:STN:280:CSaD2Mjpt1U%3D Occurrence Handle716450

    CAS  PubMed  Google Scholar 

  12. JL Madden JY Chun S Kandalaft M Parekn (1970) ArticleTitleCholedochoduodenostomy: an unjustly maligned surgical procedure? Am J Surg 119 45–54 Occurrence Handle1:STN:280:CS%2BD1cfoslQ%3D Occurrence Handle5411668

    CAS  PubMed  Google Scholar 

  13. F Nakayama (1982) ArticleTitleIntrahepatic calculi: a special problem in East Asia. World J Surg 6 802–804 Occurrence Handle1:STN:280:BiyD1MrkvFc%3D Occurrence Handle7180014

    CAS  PubMed  Google Scholar 

  14. Y Panis PL Fagniez Td Brisse F Lacaine H Levard JM Hay (1993) ArticleTitleLong term results of choledochoduodenostomy versus choledochojejunostomy for choledocholithiasis. Surg Gynecol Obstet 177 33–37 Occurrence Handle1:STN:280:ByyA3M%2Fmt1U%3D Occurrence Handle8322146

    CAS  PubMed  Google Scholar 

  15. P Parrilla P Ramirez F Sanchez Bueno JM Perez MF Candel MS Muelas (1991) ArticleTitleLong term results of choledochoduodenostomy in the treatment of choledocholithiasis: assessment of 225 cases. Br J Surg 78 470–472 Occurrence Handle1:STN:280:By6B3srgt1U%3D Occurrence Handle2032108

    CAS  PubMed  Google Scholar 

  16. M Rhodes L Nathanson (1996) ArticleTitleLaparoscopic choledochoduodenostomy. Surg Laparosc Endosc 6 318–321 Occurrence Handle10.1097/00019509-199608000-00015 Occurrence Handle1:STN:280:BymH3sjosV0%3D Occurrence Handle8840458

    Article  CAS  PubMed  Google Scholar 

  17. H Riedel (1888) ArticleTitleÜber den zungenförmigen Fortastz des rechten Lebberlappens und seine pathognostiche Bedeutung fur die Erkrankungen der Gallenblase nebst bemerkungen Gallenstein Operationen. Berl Klin Wochenschr 25 577–602

    Google Scholar 

  18. RL Sanders (1946) ArticleTitleIndications and value of choledochoduodenostomy. Ann Surg 123 847–858

    Google Scholar 

  19. O Sprengel (1891) ArticleTitleÜber einen Fall von Extirpation der Gallanblase mit Anlegung einer Communication zwischen Ductus Choledochus und Duodenum. Arch Klin Chir 124 1913

    Google Scholar 

  20. CN Tang MKW Li (2002) ArticleTitleHand-assisted laparoscopic segmentectomy in recurrent pyogenic cholangitis. Surg Endosc 17 324–327 Occurrence Handle10.1007/s00464-001-8278-4

    Article  Google Scholar 

  21. CN Tang MKW Li (2002) ArticleTitleLaparoscopic-assisted liver resection. J Hepatobil Pancreat Surg 9 105–110 Occurrence Handle10.1007/s005340200011

    Article  Google Scholar 

  22. R Tinoco L El-Kadre A Tinoco (1999) ArticleTitleLaparoscopic choledochoduodenostomy. J Laparosc Adv Surg Proc 9 123–126 Occurrence Handle1:STN:280:DyaK1M3kvFChtA%3D%3D

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3, Lok Man Road, Chai Wan, Hong Kong, People’s Republic of China

    C. N. Tang, W. T. Siu, J. P. Y. Ha & M. K. W. Li

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  1. C. N. Tang
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  2. W. T. Siu
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  3. J. P. Y. Ha
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  4. M. K. W. Li
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Correspondence to C. N. Tang.

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Tang, C., Siu, W., Ha, J. et al. Laparoscopic choledochoduodenostomy . Surg Endosc 17, 1590–1594 (2003). https://doi.org/10.1007/s00464-002-8737-6

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