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  • Eksploracija duktusa holedohusa med laparoskopsko holecistektomijo = Common bile duct exploration during laparoscopic cholecystectomy
    Vračko, Jože
    Background. One-stage laparoscopic management of patients with gallbladder andbile duct stones is superior to two-stage endoscopic and laparoscopic management. Aim. Laparoscopic procedures and ... results of modern one-stage management of patients operated on for cholecystolithiasis and bile duct stones are presented. Patients and methods. The paper outlines indications forthe laparoscopic management of gallbladder and bile duct stones and describes laparoscopic preparation of the cystic duct, laparoscopic cholangiography and common bile duct exploration by the transcystic approach and choledochotomy. Resulrs. According to the results of 20 studies involving 1,762 patients, documented in the Index Medicus data base, laparoscopic transcystic common bile duct exploration was performed in 70% of the patients and laparoscopic exploration by choledochotomy in 30%. The stone clearance rate was 94% (range 75 - 100%), operative time 120 minutes ( 60 - 480 min), conversion rate 3.6%, average length of hospital stay 4 days (1.3 - 11 days), intraoperative complication rate 0 - 1.8%, postoperative complication rate 1.6- 15.2%, retained calculi rate 2.9% ( 0.9 - 19%) and mortality 1.1%. In ourseries, the success rate of common bile duct exploration was 78%. The procedure was mostly accomplished by the transcystic approach, there were no intraoperative or postoperative complications, the length of hospital stay wasshort, and the mortality was nil. Conclusions. Common bile duct explorationduring laparoscopic cholecystectomy is a modern one-stage treatmentprocedure for patients operated on for cholecystolithiasis and choledocholithiasis. Its advantages include short hospital stay, short recovery period and preservation of the sphincter of Oddi function.
    Vir: Kirurgija žolčnika in žolčevodov : zbornik simpozija = Biliary surgery : proceedings of the symposium, Ljubljana 2003 (Str. 100-107)
    Vrsta gradiva - prispevek na konferenci
    Leto - 2003
    Jezik - slovenski
    COBISS.SI-ID - 17041369

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