An Alternative Technique for Treatment of Choledocholithiasis Found at Laparoscopic Cholecystectomy

Robert Joseph Fitzgibbons, Ardith A. Ryberg, Kenan M. Ulualp, Nam X. Nguyen, Bradley S. Litke, Jose Camps, Thomas R. Mcginn, Joseph X. Jenkins, Charles Filipi

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

To introduce a new strategy for dealing with abnormal cholangiograms at laparoscopic cholecystectomy that makes postoperative cholangiograms possible and facilitates stone extraction by assuring access to the duct for a guide-wire—assisted endoscopic retrograde sphincterotomy. Retrospective review of a prospectively maintained database. Twenty-four patients with abnormal cholangiograms had a percutaneously placed double-lumen catheter threaded through the cystic duct and advanced into the duodenum. Ten successful guide-wire—assisted endoscopic retrograde sphincterotomies were performed without complications. Eleven normal postoperative cholangiograms suggested spontaneous stone passage or false-positive intraoperative cholangiograms. There were three technical failures in the early part of the series. This strategy is a reasonable alternative to laparoscopic common bile duct exploration (1) when the cholangiogram is questionably positive, (2) when prolonged anesthesia (poor-risk patient) should be avoided, (3) when the equipment for laparoscopic common bile duct exploration is not available, and (4) when spontaneous stone passage seems likely. Postoperative endoscopic retrograde sphincterotomy with stone extraction is facilitated when it becomes necessary because a guide wire can be introduced through the catheter.

Original languageEnglish
Pages (from-to)638-642
Number of pages5
JournalArchives of Surgery
Volume130
Issue number6
DOIs
StatePublished - 1995

Fingerprint

Choledocholithiasis
Endoscopic Sphincterotomy
Laparoscopic Cholecystectomy
Common Bile Duct
Catheters
Cystic Duct
Duodenum
Therapeutics
Anesthesia
Databases
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

An Alternative Technique for Treatment of Choledocholithiasis Found at Laparoscopic Cholecystectomy. / Fitzgibbons, Robert Joseph; Ryberg, Ardith A.; Ulualp, Kenan M.; Nguyen, Nam X.; Litke, Bradley S.; Camps, Jose; Mcginn, Thomas R.; Jenkins, Joseph X.; Filipi, Charles.

In: Archives of Surgery, Vol. 130, No. 6, 1995, p. 638-642.

Research output: Contribution to journalArticle

Fitzgibbons, Robert Joseph ; Ryberg, Ardith A. ; Ulualp, Kenan M. ; Nguyen, Nam X. ; Litke, Bradley S. ; Camps, Jose ; Mcginn, Thomas R. ; Jenkins, Joseph X. ; Filipi, Charles. / An Alternative Technique for Treatment of Choledocholithiasis Found at Laparoscopic Cholecystectomy. In: Archives of Surgery. 1995 ; Vol. 130, No. 6. pp. 638-642.
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