Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 11 , ISSUE 3 ( September-December, 2022 ) > List of Articles

REVIEW ARTICLE

Laparoscopic Common Bile Duct Exploration for the Acute Care Surgeon

Elise A Biesboer, Patrick B Murphy

Keywords : Choledocholithiasis, Laparoscopic common bile duct exploration, Review article, Transcystic

Citation Information : Biesboer EA, Murphy PB. Laparoscopic Common Bile Duct Exploration for the Acute Care Surgeon. Panam J Trauma Crit Care Emerg Surg 2022; 11 (3):156-162.

DOI: 10.5005/jp-journals-10030-1395

License: CC BY-NC 4.0

Published Online: 31-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: To provide the acute care surgeon with an overview, technical description, and discussion of the benefits of laparoscopic common bile duct exploration to promote surgically focused care of gallstone disease. Background: Gallstone disease is one of the most common surgical conditions worldwide. Choledocholithiasis imparts specific management concerns and challenges. Currently, most suspected choledocholithiasis is managed via a two-stage approach by clearing the biliary tree preoperatively, followed by laparoscopic cholecystectomy (LC). Laparoscopic common bile duct exploration (LCBDE) is an attractive, one-stage surgical approach to manage choledocholithiasis; however, it has become a lost skill for modern surgeons. Transcystic (TC) LCBDE has been shown to be as successful as alternative methods and offers a low complication rate and short length of hospital stay. Clinical significance: Although most surgeons do not currently perform LCBDE, surgically focused care of choledocholithiasis promotes improved patient care through a single anesthetic and low complication rate. Surgeons and hospital systems also benefit from increased surgical expertise, shorter length of hospital stay, and potentially decreased costs. Conclusion: Surgeons and systems should focus on shifting the balance toward surgically based care for the management of suspected and confirmed choledocholithiasis. The review focuses on strategies to promote a surgery-first approach to choledocholithiasis.


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