Single-Incision Laparoscopic Common Bile Duct Exploration with Conventional Instruments: an Innovative Technique and a Comparative Study.
- Resource Type
- Article
- Authors
- Chuang, Shu-Hung; Chen, Pai-Hsi; Chang, Chih-Ming; Tsai, Yung-Fa; Lin, Chih-Sheng
- Source
- Journal of Gastrointestinal Surgery. Apr2014, Vol. 18 Issue 4, p737-743. 7p.
- Subject
- *LAPAROSCOPIC surgery
*COMPARATIVE studies
*TECHNOLOGICAL innovations
*RETROSPECTIVE studies
*GALLSTONES
*FOLLOW-up studies (Medicine)
*RANDOMIZED controlled trials
*PATIENTS
BILE duct surgery
- Language
- ISSN
- 1091-255X
Background: Single-incision laparoscopic surgery developed rapidly in recent years. We introduce an innovative technique: single-incision laparoscopic common bile duct exploration (SILCBDE) with conventional instruments. A retrospective comparison between SILCBDE and standard laparoscopic common bile duct exploration (LCBDE) was analyzed. Methods: Thirty-four patients who underwent LCBDE for choledocholithiasis in a period of 17 months were enrolled. Seventeen standard LCBDEs and 17 SILCBDEs were attempted. Simultaneous cholecystectomies were performed. Results: The stone clearance rate was 94.1 % (16 patients) in the standard LCBDE group and 100 % in the SILCBDE group. There was no statistical difference in demographic distribution, clinical presentations, and operative results between the two groups, except the SILCBDE group had a higher rate of acute cholecystitis than the standard LCBDE group (76.5 vs. 35.3 %; p < 0.05). One procedure (5.9 %) in the SILCBDE group was converted to a four-incision transcystic LCBDE. The complication rate was 11.8 % (two patients) in the standard LCBDE group and 5.9 % (one patient) in the SILCBDE group. The average follow-up period was 4.2 months. Conclusion: SILCBDE is as safe and efficacious as standard LCBDE in experienced hands. Choledochoscope manipulation and bile duct repair are the key skills. Long-term follow-up and further prospective randomized trials are anticipated. [ABSTRACT FROM AUTHOR]