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LETTER TO EDITOR
Year : 2010  |  Volume : 6  |  Issue : 1  |  Page : 24-25
 

Laparoscopic removal of worm in biliary canal


Wiwanitkit House, Bangkhae, Bangkok, Thailand 10160, Thailand

Date of Web Publication15-Apr-2010

Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok, Thailand 10160
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.62533

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How to cite this article:
Wiwanitkit V. Laparoscopic removal of worm in biliary canal. J Min Access Surg 2010;6:24-5

How to cite this URL:
Wiwanitkit V. Laparoscopic removal of worm in biliary canal. J Min Access Surg [serial online] 2010 [cited 2020 Jan 24];6:24-5. Available from: http://www.journalofmas.com/text.asp?2010/6/1/24/62533


Sir,

With great interest, I read the recent publication on 'using laparoscopic approach for removal of worm from biliary canal'. [1] Chalkoo et al. succeeded in using a hard laparoscopic procedure for removal of the worm Ascaris spp. Chalkoo et al. concluded that "with advancement and more familiarity in laparoscopic surgeries, we advocate laparoscopic removal of dead worms in biliary ascariasis in failed ERCP cases." [1] Indeed, the laparoscopic approach for removal of parasite from biliary tract is mentioned as an effective alternative. Effectiveness of this approach is also confirmed in cases of parasitosis with concomitant biliary stone. [2] However, its use after failure of another non-invasive approach, viz., ERCP, is still questionable. I accept and admire the high surgical skill of Chalkoo et al.; however, the rationale of using laparoscopic removal in cases of failed ERCP should be carefully rethought. As Chalkoo et al. have noted, the high risk of biliary tract injury during laparoscopic procedure is a big problem preventing success of laparoscopic procedure. In addition, there might be some problems in the selection of proper size of surgical tools for removal of worm from the biliary tract. This might be a repeated problematic area if the surgeon misestimates the size of parasite and the occulted local biliary canal structural disorder. In general, the classical surgical procedure might be more favourable if the surgeon is not highly skilled in laparoscopic practice and does not have good imaging diagnostic tools.

 
  References Top

1.Chalkoo M, Masoodi I, Hussain S, Chalkoo S, Farooq O. Laparoscopic exploration of the common bile duct and removal of dead worm in a patient of cholangitis after endoscopic retrograde cholangiopancreatography failure. J Min Access Surg 2009;5:82-4.  Back to cited text no. 1  [PUBMED]  Medknow Journal  
2.Yoshihara S, Toyoki Y, Takahashi O, Sasaki M. Laparoscopic treatment for biliary ascariasis. Surg Laparosc Endosc Percutan Tech 2000;10:103-5.  Back to cited text no. 2  [PUBMED]    




 

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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04