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Volume 11
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10.22543/2392-7674.1563
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Journal of Mind and Medical Sciences is published by MDPI from Volume 12 Issue 1 (2025). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Valparaiso University (ValpoScholar).
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Article

Approaches and Indications in Laparoscopic Choledoscopy

by
Iulian Slavu
1,2,
Raluca Tulin
3,
Ileana Dima
2,
Alexandru Dogaru
2,
Florin Filipoiu
1,
Bogdan Socea
4,*,
Anca Monica Oprescu-Macovei
5 and
Adrian Tulin
1,2
1
Department of Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
2
Department of General Surgery, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, Romania
3
Department of Endocrinology, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, Romania
4
Department of Surgery, St. Pantelimon, Emergency Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
5
Department of Gastroenterology, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, Romania
*
Author to whom correspondence should be addressed.
J. Mind Med. Sci. 2024, 11(2), 482-487; https://doi.org/10.22543/2392-7674.1563
Submission received: 11 August 2024 / Revised: 11 September 2024 / Accepted: 26 September 2024 / Published: 31 October 2024

Abstract

Objectives. Up to 20% of patients with biliary lithiasis have bile duct stones, which are asymptomatic in 50% of cases. The aim of the study was to evaluate the role of choledoscopy in extracting stones from the main bile ducts. Materials and Methods. This is a retrospective study (January 2014–December 2024) on 2309 patients who underwent a laparoscopic cholecystectomy. Laparoscopic choledoscopy was performed in 32 cases. Of the 32 patients with complete clearance, none had residual common bile duct stones (CBDS) at 1 year postoperatively. Results. The ideal approach in our study was the transcystic approach, with the shortest hospital stays (mean 3 days) transcholedochal approach; it was only feasible in 7 patients. All patients had transcystic drainage that was removed after 10 days (mean operative time 105 min). The transcholedochal approach was demanding from a technical point of view. Primary ductal closure was performed in 5 patients. Ductal closure with transcystic drain was in 9 patients. A total of 14 patients had a T-tube and a longer operative time (on average 170 min). Conversion to open surgery was performed in 4 cases, due to difficult dissection at the level of the hepatic porta. Conclusions. LCBDE for previously documented or discovered CBDS during LC is a safe and feasible procedure. The technique is technically demanding, and requires advanced laparoscopic skills. Patient selection is very important, but the transcystic approach for LCBDE when possible is optimal.
Keywords: choledoscopy; laparoscopy; surgery; approaches; indications choledoscopy; laparoscopy; surgery; approaches; indications

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MDPI and ACS Style

Slavu, I.; Tulin, R.; Dima, I.; Dogaru, A.; Filipoiu, F.; Socea, B.; Oprescu-Macovei, A.M.; Tulin, A. Approaches and Indications in Laparoscopic Choledoscopy. J. Mind Med. Sci. 2024, 11, 482-487. https://doi.org/10.22543/2392-7674.1563

AMA Style

Slavu I, Tulin R, Dima I, Dogaru A, Filipoiu F, Socea B, Oprescu-Macovei AM, Tulin A. Approaches and Indications in Laparoscopic Choledoscopy. Journal of Mind and Medical Sciences. 2024; 11(2):482-487. https://doi.org/10.22543/2392-7674.1563

Chicago/Turabian Style

Slavu, Iulian, Raluca Tulin, Ileana Dima, Alexandru Dogaru, Florin Filipoiu, Bogdan Socea, Anca Monica Oprescu-Macovei, and Adrian Tulin. 2024. "Approaches and Indications in Laparoscopic Choledoscopy" Journal of Mind and Medical Sciences 11, no. 2: 482-487. https://doi.org/10.22543/2392-7674.1563

APA Style

Slavu, I., Tulin, R., Dima, I., Dogaru, A., Filipoiu, F., Socea, B., Oprescu-Macovei, A. M., & Tulin, A. (2024). Approaches and Indications in Laparoscopic Choledoscopy. Journal of Mind and Medical Sciences, 11(2), 482-487. https://doi.org/10.22543/2392-7674.1563

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