Detailed Abstract
[E-poster - Biliary & Pancreas (Biliary Disease/Surgery)]
[EP 156] Outcomes of Laparoscopic Choledochotomy Using Cholangioscopy Via Percutaneous-choledochal Tube for Treatment of Hepatolithiasis And Choledocholithiasis: a Preliminary Vietnamese Study
Quang VU VAN 1, Thanh LE VAN 1, Hieu LE TRUNG 1, Anh NGUYEN HOANG NGOC 1, Thang TRAN MANH 2, Loi LE VAN 1
1 Department of HBP Surgery And Liver Transplant, 108 Military Central Hospital, VIETNAM, 2 Department of Surgery, Vin University, VIETNAM
Background : Hepatolithiasis and choledocholithiasis are frequent pathologies; unfortunately, current strategies have high recurrence incidence. This study aimed to assess the outcomes of laparoscopic choledochotomy using cholangioscopy via the percutaneous-choledochal tube for treating hepatolithiasis and choledocholithiasis in Vietnamese patients.
Methods : A cross-sectional study of patients with hepatolithiasis and/or choledocholithiasis who underwent laparoscopic choledochotomy using intraoperative cholangioscopy via percutaneous-choledochal tube at Departments of Hepatopancreatobiliary Surgery, 108 Military Central Hospital, from June 2017 to March 2020.
Results : A total of 84 patients were analyzed. Most patients were females (56%) with a median age of 55.56. 41.8% of patients had previous abdominal operations, with 33.4% having choledochotomy. All patients underwent successful laparoscopic common bile duct exploration followed by T-tube drainage without needing to convert to open surgery. Most patients (64.3%) have both intrahepatic and extrahepatic stones. Regarding stones’ size, the rate of stones ≥ 10mm in diameter was 64.3%. Biliary strictures were observed in 19.1% of patients during cholangioscopy. Complete removal of stones was achieved in 54.8% of patients. The intraoperative complications were encountered in two patients, but no need to change the strategy. The mean operating time was 121.85 ± 30.47 minutes. The early postoperative complication rate was 9.6%, all managed conservatively. The residual stones were removed through the T-tube tract by subsequent choledochoscopy in 34/38 patients, so the total success rate was 95.2%.
Conclusions : Laparoscopic choledochotomy combined with cholangioscopy through the percutaneous-choledochal tube was a safe and effective strategy for hepatolithiasis and/or choledocholithiasis, even in patients with previous choledochotomy.
Methods : A cross-sectional study of patients with hepatolithiasis and/or choledocholithiasis who underwent laparoscopic choledochotomy using intraoperative cholangioscopy via percutaneous-choledochal tube at Departments of Hepatopancreatobiliary Surgery, 108 Military Central Hospital, from June 2017 to March 2020.
Results : A total of 84 patients were analyzed. Most patients were females (56%) with a median age of 55.56. 41.8% of patients had previous abdominal operations, with 33.4% having choledochotomy. All patients underwent successful laparoscopic common bile duct exploration followed by T-tube drainage without needing to convert to open surgery. Most patients (64.3%) have both intrahepatic and extrahepatic stones. Regarding stones’ size, the rate of stones ≥ 10mm in diameter was 64.3%. Biliary strictures were observed in 19.1% of patients during cholangioscopy. Complete removal of stones was achieved in 54.8% of patients. The intraoperative complications were encountered in two patients, but no need to change the strategy. The mean operating time was 121.85 ± 30.47 minutes. The early postoperative complication rate was 9.6%, all managed conservatively. The residual stones were removed through the T-tube tract by subsequent choledochoscopy in 34/38 patients, so the total success rate was 95.2%.
Conclusions : Laparoscopic choledochotomy combined with cholangioscopy through the percutaneous-choledochal tube was a safe and effective strategy for hepatolithiasis and/or choledocholithiasis, even in patients with previous choledochotomy.
SESSION
E-poster
E-Session 03/21 ALL DAY