Journal of Minimal Access Surgery

ORIGINAL ARTICLE
[View FULLTEXT] [Download PDF]
Year : 2007  |  Volume : 3  |  Issue : 1  |  Page : 19--25

Antegrade common bile duct (CBD) stenting after laparoscopic CBD exploration

Samik Kumar Bandyopadhyay, Shashi Khanna, Bimalendu Sen, Om Tantia 
 Department of Minimal Access Surgery, ILS Multispeciality Clinic, Salt Lake City, Kolkata, India

Correspondence Address:
Om Tantia
Department of Minimal Access Surgery, ILS Multispeciality Clinic, DD-6, Sector I, Salt Lake City, Kolkata - 700 064
India

Laparoscopic common bile duct exploration (LCBDE) has been found to be a safe, efficient and cost-effective treatment for choledocholithiasis. Following LCBDE, the clearance may be ascertained by a cholangiogram or choledochoscopy. The common bile duct (CBD) may be closed primarily with or without a stent in situ or may be drained by means of a T-tube or a biliary enteric anastomosis. Materials and Methods: In our series of 464 patients of choledocholithiasis, 100 patients underwent closure of the CBD with an indwelling antegrade stent following LCBDE. LCBDE was performed by direct massage of CBD, saline lavage, direct pickup with choledocholithotomy forceps or by basketing. Fragmentation of impacted stones in situ was performed in a few patients. Completion choledochoscopy was performed by means of a pediatric bronchoscope. A 10-cm, 7 Fr. double-flap biliary stent was placed in situ after LCBDE. Results: There was no mortality in the series. There was no conversion either. The median duration of the operation was 75 min. The mean postoperative hospital stay was 3.5 days. One patient had a minor postoperative biliary leak. One patient had a right sub-hepatic collection. Four patients developed postoperative port infection. The stents were removed endoscopically after 4 weeks. Sixty-eight patients could be followed up till 1 year. There has been no incidence of residual disease and the patients on follow-up are asymptomatic. Conclusion: In our experience, a single stage laparoscopic treatment of cholelithiasis with choledocholithiasis is a safe, viable and cost-effective option. Closure of the CBD over an antegrade stent is a feasible option but requires advanced skills in minimal access surgical techniques, especially endosuturing. The procedure may be performed safely in expert hands without mortality and with negligible morbidity.


How to cite this article:
Bandyopadhyay SK, Khanna S, Sen B, Tantia O. Antegrade common bile duct (CBD) stenting after laparoscopic CBD exploration.J Min Access Surg 2007;3:19-25


How to cite this URL:
Bandyopadhyay SK, Khanna S, Sen B, Tantia O. Antegrade common bile duct (CBD) stenting after laparoscopic CBD exploration. J Min Access Surg [serial online] 2007 [cited 2019 Jun 16 ];3:19-25
Available from: http://www.journalofmas.com/article.asp?issn=0972-9941;year=2007;volume=3;issue=1;spage=19;epage=25;aulast=Bandyopadhyay;type=0