Assessment and treatment of choledocholithiasis when endoscopic sphincterotomy is not successful

• Verfasst von: Shojaiefard, Abolfazl [VerfasserIn]
• Verfasst von: Esmaeilzadeh, Majid [VerfasserIn]
• Titel: Assessment and treatment of choledocholithiasis when endoscopic sphincterotomy is not successful
• Verf.angabe: Abolfazl Shojaiefard MD, Majid Esmaeilzadeh MD, Zhamak Khorgami MD, Rasoul Sotoudehmanesh MD, Ali Ghafouri MD
• Jahr: 2012
• Jahr des Originals: 2011
• Umfang: 4 S.
• Fussnoten: "012155/AIM.006" ist bei PubMed fälschlicherweise als DOI angegeben ; Published online: 21 October 2011 ; Gesehen am 06.08.2018
• Titel Quelle: Enthalten in: Archives of Iranian medicine
• Ort Quelle: Shiraz, 1998
• Jahr Quelle: 2012
• Band/Heft Quelle: 15(2012), 5, Seite 275-278
• ISSN Quelle: 1029-2977
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: CHI-squared test
• Sach-SW: Choledochoduodenostomy
• Sach-SW: Choledochojejunostomy
• Sach-SW: Choledocholithiasis
• Sach-SW: DATA analysis software
• Sach-SW: ENDOSCOPIC retrograde cholangiopancreatography
• Sach-SW: ENDOSCOPY
• Sach-SW: ERCP
• Sach-SW: GALLSTONE diagnosis
• Sach-SW: GALLSTONE treatment
• Sach-SW: RETROSPECTIVE studies
• Sach-SW: T-test (Statistics)
• Sach-SW: TIME
• Sach-SW: TREATMENT effectiveness
• K10plus-PPN: 1578297478

Abstract

Background: Choledocholithiasis exists in approximately 15% of patients with gallstones and is present in 3%-10% of those undergoing cholecystectomy. Methods: In this study, we retrospectively analyzed the outcome patients with choledocholithiasis that were managed by open common bile duct (CBD) exploration according to our center's protocol. Endoscopic retrograde cholangiopancreatography (ERCP) was performed for CBD stone clearance. If ERCP and sphincterotomy were not successful, open surgical exploration of CBD was performed with T-tube insertion without routine intraoperative cholangiography (IOC). Results: We studied 1462 patients with choledocholithiasis. ERCP was successful in in 1276 (87.2%) patients. A total of 186 (12.8%) underwent surgery. Of these, 82 (45.2%) had CBD exploration and T-tube insertion without IOC. Choledochoduodenostomy was performed in 82 (44.1%) patients and choledochojejunostomy was performed in 20 (10.8%). Retained stones were found only in 4 cases which were treated by ERCP. Conclusion: ERCP is successful in most cases with choledocholithiasis. If ERCP fails, open exploration of CBD and T-tube insertion, or biliary-enteric anastomosis are acceptable ways for CBD drainage. The rate of retained stone is not more than expected, thus elective IOC is more acceptable than routine IOC. Routine IOC is time-consuming and particularly difficult in elderly patients and emergency conditions.