Avtor/Urednik		Szinicz, G; Ebner, S; Beller, S; Erhart, K
Naslov		Laparoscopic management of common bile duct stones
Tip		članek
Vir		In: Jelenc F, editor. Zbornik simpozija Kirurgija žolčnika in žolčevodov; 2003 okt; Ljubljana. Ljubljana: Klinični center, Klinični oddelek za abdominalno kirurgijo,
Leto izdaje		2003
Obseg		str. 179-85
Jezik		eng
Abstrakt		Background. While laparoscopic cholecystectomy is widely accepted for therapy of cholecystolithiasis, controversy still exists concerning the management of common bile duct stones. Besides preoperative endoscopic papillotomy (therapeutic splitting) and open common bile duct surgery, management of common bile duct stones can be conducted by minimal invasive surgery, if respective experience is available. Method. During laparoscopic cholecystectomy a cholangiography via the cystic duct is routinely performed. If bile duct stones are detected they are retrieved via the cystic duct or via incision of the common bile duct by insertion of Fogarty catheter or Dormia basket. Exclusion criteria against simultaneous laparoscopic management include suspicion of malignancy, severe pancreatitis or cholangitis. Results: From November 1991 to March 2003, 219 patients primarily underwent laparoscopic therapy of bile duct stones. Retrieval was performed via cystic duct and common bile duct incision in 155 and 74 cases, respectively. Complete removal was achieved in 92%, complication rate and mortality was 7% and 0.5%, respectively. During the same period therapeutic splitting was necessary in 40 patients due to the above contraindications. Conclusions. When correct indications and surgical expertise are met, simultaneous laparoscopic management of common bile duct stones represents a save and minimal invasive alternative to therapeutic splitting. During the last decade, laparoscopic cholecystectomy rapidly developed to become the standard procedure for management of symptomatic cholecystolithiasis. However, controversy still exists concerning the optimal therapy of simultaneous common bile duct stones. The frequency of simultaneous presence of bile duct stones varies from 8 to 19%, increasing with age [6, 20]. (Abstract truncated at 2000 characters).
Deskriptorji		COMMON BILE DUCT CALCULI CHOLECYSTECTOMY, LAPAROSCOPIC TREATMENT OUTCOME