Abstract
Background
Given the limitations and risks associated with current treatments for common bile duct (CBD) stones, the authors placed a spontaneously removed endobiliary J stent in the distal CBD to decompress the biliary tract and performed a primary closure of the CBD after laparoscopic common bile duct exploration (LCBDE).
Methods
In this study, 10 of 14 patients with a diagnosis of choledocholithiasis were successfully treated using LCBDE. After extraction of the CBD stones using a choledoscope, a J-shaped stent was placed into the distal CBD as an internal drainage. The J stent was fixed with a rapid absorbable suture at the choledochotomy, which was closed by primary suture.
Results
The procedures for all 10 patients were successfully completed. No complications related to placement of the endobiliary J stents were observed postoperatively. None of the patients reported discomfort, and the J stents passed spontaneously 2 to 3 weeks after discharge.
Conclusion
Spontaneously removed endobiliary J-stent drainage is a safe and effective surgical technique that allows for straightforward postoperative management after LCBDE.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sorensen VJ, Buck JR, Chung SK, Fath JJ, Horst HM, Obeid FN (1994) Primary common bile duct closure following exploration: an effective alternative to routine biliary drainage. Am Surg 60:451–454
Croce E, Golia M, Azzola M, Russo R, Crozzoli L, Olmi S, Pompa C, Borzio M (1996) Laparoscopic choledochotomy with primary closure: follow-up (5–44 months) of 31 patients. Surg Endosc 10:1064–1068
Ha JP, Tang CN, Siu WT, Chau CH, Li MK (2004) Primary closure versus T-tube drainage after laparoscopic choledochotomy for common bile duct stones. Hepatogastroenterology 51:1605–1608
Decker G, Borie F, Millat B, Berthou JC, Deleuze A, Drouard F, Guillon F, Rodier JG, Fingerhut A (2003) One hundred laparoscopic choledochotomies with primary closure of the common bile duct. Surg Endosc 17:12–18
Gurusamy KS, Samraj K (2007) Primary closure versus T-tube drainage after laparoscopic common bile duct stone exploration. Cochrane Database Syst Rev 24:CD005641
Holdsworth RJ, Sadek SA, Ambikar S, Cuschieri A (1989) Dynamics of bile flow through the choledochal sphincter following exploration of the common bile duct. World J Surg 13:300–304
DePaula AL, Hashiba K, Bafutto M, Machado C, Ferrari A, Machado MM (1998) Results of the routine use of a modified endoprosthesis to drain the common bile duct after laparoscopic choledochotomy. Surg Endosc 12:933–935
Isla AM, Griniatsos J, Wan A (2002) A technique for safe placement of a biliary endoprosthesis after laparoscopic choledochotomy. J Laparoendosc Adv Surg Tech A 12:207–211
Gersin KS, Fanelli RD (1998) Laparoscopic endobiliary stenting as an adjunct to common bile duct exploration. Surg Endosc 12:301–304
Cuschieri A, Lezoche E, Morino M, Croce E, Lacy A, Toouli J, Faggioni A, Ribeiro VM, Jakimowicz J, Visa J, Hanna GB (1999) E.A.E.S. multicenter prospective randomized trial comparing two-stage vs single-stage management of patients with gallstone disease and ductal calculi. Surg Endosc 13:952–957
Urbach DR, Khajanchee YS, Jobe BA, Standage BA, Hansen PD, Swanstrom LL (2001) Cost-effective management of common bile duct stones: a decision analysis of the use of endoscopic retrograde cholangiopancreatography (ERCP), intraoperative cholangiography, and laparoscopic bile duct exploration. Surg Endosc 15:4–13
Christoforidis E, Goulimaris I, Kanellos I, Tsalis K, Demetriades C, Betsis D (2002) Post-ERCP pancreatitis and hyperamylasemia: patient-related and operative risk factors. Endoscopy 34:286–292
Christensen M, Matzen P, Schulze S, Rosenberg J (2004) Complications of ERCP: a prospective study. Gastrointest Endosc 60:721–731
Sackmann M, Holl J, Sauter GH, Pauletzki J, von Ritter C, Paumgartner G (2001) Extracorporeal shock wave lithotripsy for clearance of bile duct stones resistant to endoscopic extraction. Gastrointest Endosc 53:27–32
Ellis RD, Jenkins AP, Thompson RP, Ede RJ (2000) Clearance of refractory bile duct stones with extracorporeal shockwave lithotripsy. Gut 47:728–731
Leida Z, Ping B, Shuguang W, Yu H (2008) A randomized comparison of primary closure and T-tube drainage of the common bile duct after laparoscopic choledochotomy. Surg Endosc 22:1595–1600
Wei Q, Cai X, Yang J, Li J (2004) A modified transcystic biliary decompression after laparoscopic choledochotomy. J Laparoendosc Adv Surg Tech A 14:27–30
Wenner DE, Whitwam P, Rosser J, Hashmi S, Wenner DEIII (2005) A stone extraction facilitation device to achieve an improved technique for performing LCBDE. Surg Endosc 19:120–125
Wood T, Macfadyen BV Jr (2000) Diagnostic and therapeutic choledochoscopy. Semin Laparosc Surg 7:288–294
Topal B, Aerts R, Penninckx F (2007) Laparoscopic common bile duct stone clearance with flexible choledochoscopy. Surg Endosc 21:2317–2321
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Huang, J., Zhu, J. Spontaneously removed endobiliary J stent drainage after laparoscopic common bile duct exploration. Surg Endosc 23, 1398–1402 (2009). https://doi.org/10.1007/s00464-009-0368-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-009-0368-8