6. Single-step laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography in patients with cholecysto-choledocholithiasis

Tran Bao Long, Trinh Quoc Dat, Le Quang Hung, Tran Duy Hung, Nguyen Duc Anh

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Tóm tắt

Current treatment of complicated calculous biliary disease typically involves a two-step procedure consisting of pre- or post-operative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC). This practice creates drawbacks as there is the need for two anesthesia inductions and longer hospital stay. The combination of LC and ERCP (LC + ERCP) for patients with cholecysto-choledocholithiasis has shown safety advantages, reducing anesthesia inductions and bringing high efficiency. This is a retrospective case series implemented at the Department of General Surgery - Hanoi Medical University Hospital between March 2020 and July 2022. In total, 44 patients met the criteria of this study. The average age of the cohort was 55.43 ± 18.12 years. The mean operating times of ERCP and LC were 58.05 ± 20.10 min and 54.09 ± 23.80 min, respectively. There was one intra-operative adverse event and no conversion. The mean hospital stay was 3.95 ± 2.28 days, and the rate of stones clearance was 100 per cent. LC combine ERCP in a single setting is a safe, effective procedure in treating cholecysto-choledocholithiasis.

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Tài liệu tham khảo

1. Jones M, Johnson M, Samourjian E, et al. ERCP and laparoscopic cholecystectomy in a combined (one-step) procedure: a random comparison to the standard (two-step) procedure. Surg Endosc. 2013;27(6):1907-1912. doi:10.1007/s00464-012-2647-z
2. Liverani A, Muroni M, Santi F, et al. One-step Laparoscopic and Endoscopic Treatment of Gallbladder and Common Bile Duct Stones: Our Experience of the Last 9 Years in a Retrospective Study. The American Surgeon. 2013;79(12):1243-1247. doi:10.1177/000313481307901213
3. Wandling MW, Hungness ES, Pavey ES, et al. Nationwide Assessment of Trends in Choledocholithiasis Management in the United States From 1998 to 2013. JAMA Surg. 2016;151(12):1125. doi:10.1001/jamasurg.2016.2059
4. Cuschieri A, Lezoche E, Morino M, et al. 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. 1999;13(10):952-957. doi:10.1007/s004649901145
5. Tan C, Ocampo O, Ong R, et al. Comparison of one stage laparoscopic cholecystectomy combined with intra-operative endoscopic sphincterotomy versus two-stage pre-operative endoscopic sphincterotomy followed by laparoscopic cholecystectomy for the management of pre-operatively diagnosed patients with common bile duct stones: a meta-analysis. Surg Endosc. 2018;32(2):770-778. doi:10.1007/s00464-017-5739-y
6. Ghazal AH, Sorour MA, El-Riwini M, et al. Single-step treatment of gall bladder and bile duct stones: A combined endoscopic–laparoscopic technique. International Journal of Surgery. 2009;7(4):338-346. doi:10.1016/j.ijsu.2009.05.005
7. Pokhrel N, Katwal G. Single Setting ERCP and Laparoscopic Cholecystectomy is a Safe Procedure in Patients with Cholecysto-Choledocholithiasis: A Prospective Study in a Peripheral-Level Hospital. Nep Med Coll J. 2020;22(1-2):73-81. doi:10.3126/nmcj.v22i1-2.30038
8. Lau JYW, Leow C, Fung TMK, et al. Cholecystectomy or Gallbladder In Situ After Endoscopic Sphincterotomy and Bile Duct Stone Removal in Chinese Patients. Gastroenterology. 2006;130(1):96-103. doi:10.1053/j.gastro.2005.10.015
9. Thaker AM, Mosko JD, Berzin TM. Post-endoscopic retrograde cholangiopancreatography pancreatitis. Gastroenterology Report. 2015;3(1):32-40. doi:10.1093/gastro/gou083
10. Williams E, Beckingham I, El Sayed G, et al. Updated guideline on the management of common bile duct stones (CBDS). Gut. 2017;66(5):765-782. doi:10.1136/gutjnl-2016-312317
11. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111. doi:10.1136/gutjnl-2012-302779
12. Borzellino G, Saladino E, Lombardo F, et al. Rendez-vous Technique. In: Biliary Lithiasis. Springer Milan; 2008:351-356. doi:10.1007/978-88-470-0763-5_26