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cbd for gallstones

Stogryn S, Metcalfe J, Vergis A, Hardy K. Does ultrasongraphy predict intraoperative findings at cholecystectomy? An institutional review. Can J Surg. 2016 Feb. 59(1):12-8. [Medline].

Shapiro T, Melzer E, Binder Y, et al. Selective utilization of pre-operative endoscopic ultrasound to exclude choledocholithiasis prior to laparoscopic cholecystectomy: a retrospective study. Hepatogastroenterology. 2013 May. 60(123):456-60. [Medline].

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Yao CC, Huang SM, Lin CC, et al. Assessment of common bile duct using laparoscopic ultrasound during laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2009 Aug. 19(4):317-20. [Medline].

Halldestam I, Kullman E, Borch K. Incidence of and potential risk factors for gallstone disease in a general population sample. Br J Surg. 2009 Nov. 96(11):1315-22. [Medline].


Mahid SS, Jafri NS, Brangers BC, Minor KS, Hornung CA, Galandiuk S. Meta-analysis of cholecystectomy in symptomatic patients with positive hepatobiliary iminodiacetic acid scan results without gallstones. Arch Surg. 2009 Feb. 144(2):180-7. [Medline].

Cbd for gallstones

In the majority of LTSE patients, the cystic duct was narrow and needed to be dilated. Dilatation was carried out first with blunt, flexible dilators introduced by a 10-mm trocar inserted upright to the cystic duct opening. After dilation, a 5-mm flexible choledochoscope was introduced into the cystic duct. Small stones were flushed out through the papilla.In the majority of cases, stones were extracted with a Dormia basket (Boston Scientific Corporation, USA) under choledochoscopic control. After extraction, a completion cholangiography was performed to detect any upper bile duct stones. If the finding was negative, then the cystic duct was closed with a hem-o-lok clip (Teleflex Medical Inc, USA). Abdominal drainage was not routinely placed unles ssevere acute cholecystitis occurred.

Surgical procedure

There were several methods in the management of patients with choledocholithiasis: Single stage laparoscopic procedures, two stage methods combining LC with pre- or post-operative ERC. For the single stage laparoscopic procedures, LC can be combined with laparoscopic exploration of the common bile duct, either as a choledochotomy or as a LTSE procedure. Preoperative Endoscopic sphincterotomy (EST) has been the procedure of choice for most physicians [10, 11]. Although the success rate for stone clearance equals 87% to 97%, ERCP and EST are associated with morbidity and mortality rates of 5% to 11% and 0.77% to 1.2%, respectively [12–15].

Table 4

For Overall, the postoperative complication rate, in the primary closure group was insignificantly lower than that in the T-tube group. Similar to the findings reported previously [20], the most complication in the T-tube group in our study was related to the use of the T-tube. Therefore, postoperative T-tube drainage is unnecessary for decompression of the biliary tree. In addition, the use of intraoperative choledochoscopy and cholangiography can also help eliminate the overlooked biliary tree diseases.