Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
World Journal of Surgery
Erschienen in: World Journal of Surgery 9/2014

01.09.2014

Transcystic or Transductal Stone Extraction during Single-Stage Treatment of Choledochocystolithiasis: A Systematic Review

verfasst von: Jan Siert K. Reinders, Dirk J. Gouma, Dirk T. Ubbink, Bert van Ramshorst, Djamila Boerma

Erschienen in: World Journal of Surgery | Ausgabe 9/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Choledochocystolithiasis can be managed by endoscopic retrograde cholangiopancreaticography (ERCP) or laparoscopically by transcystic (TC) or transductal (TD) stone extraction.

Objective

The aim of this study was to systematically review safety and effectiveness of combined endoscopic/laparoscopic management versus total laparoscopic management for choledochocystolithiasis with specific emphasis on TC versus TD stone extraction.

Methods

MEDLINE/PubMed, EMBASE, the Cochrane Library, and clinicaltrials.gov were searched systematically to identify trials on combined endoscopic/laparoscopic and total laparoscopic management for choledochocystolithiasis. Laparoscopic common bile duct (CBD) exploration was divided into TD and TC approach. Primary outcomes were successful stone clearance from CBD, postoperative/procedural morbidity, and mortality.

Results

Eight randomized trials with 965 patients were included. Successful bile duct clearance varied between 52.6 and 97 % in the ERCP groups, 80.4 and 100 % in the TC groups, and 58.3 and 100 % in the TD groups. There were more bile leaks after TD stone extraction (11 %) than after ERCP (1 %) and TC stone extraction (1.7 %). Total morbidity varied between 9.1 and 38.3 % in the ERCP groups, 7 and 10.5 % in the TC groups, and 18.4 and 26.7 % in the TD groups. Methodological and statistical heterogeneity among the trials precluded a meaningful meta-analysis.

Conclusion

Stone clearance rates are comparable between the three modalities, but TD stone extraction is associated with a higher risk of bile leaks and should only be performed by highly experienced surgeons. TC stone extraction seems a more accessible technique with lower complication rates. If unsuccessful, per- or postoperative endoscopic stone extraction is a viable option.
Literatur
1.
Collins C, Maguire D, Ireland A, Fitzgerald E, O’Sullivan GC (2004) A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy: natural history of choledocholithiasis revisited. Ann Surg 239:28–33PubMedCentralPubMedCrossRef
2.
Alkhaffaf B, Parkin E, Flook D (2011) Endoscopic retrograde cholangiopancreatography prior to laparoscopic cholecystectomy: a common and potentially hazardous technique that can be avoided. Arch Surg 146:329–333PubMedCrossRef
3.
Katz D, Nikfarjam M, Sfakiotaki A, Christophi C (2004) Selective endoscopic cholangiography for the detection of common bile duct stones in patients with cholelithiasis. Endoscopy 36:1045–1049PubMedCrossRef
4.
Hemli JM, Arnot RS, Ashworth JJ, Curtin AM, Simon RA, Townend DM (2004) Feasibility of laparoscopic common bile duct exploration in a rural centre. ANZ J Surg 74:979–982PubMedCrossRef
5.
Gonzales JJ, Sanz L, Grana JL, Bermejo G, Navarrete F, Martinez E (1997) Biliary lithiasis in the elderly patient: morbidity and mortality due to biliary surgery. Hepatogastroenterology 44:1565–1568
6.
Hammarstrom LE, Holmin T, Stridbeck H, Ihse I (1995) Long-term follow-up of a prospective randomized study of endoscopic versus surgical treatment of bile duct calculi in patients with gallbladder in situ. Br J Surg 82:1516–1521PubMedCrossRef
7.
Neoptolemos JP, Carr-Locke DL, Fossard DP (1987) Prospective randomised study of preoperative endoscopic sphincterotomy versus surgery alone for common bile duct stones. BMJ 294:470–474PubMedCentralPubMedCrossRef
8.
Targarona EM, Ayuso RM, Bordas JM, Ros E, Pros I, Martinez J, Trias M (1996) Randomised trial of endoscopic sphincterotomy with gallbladder left in situ versus open surgery for common bile duct calculi in high-risk patients. Lancet 347:926–929PubMedCrossRef
9.
Boerma D, Schwartz MP (2006) Gallstone disease. Management of common bile-duct stones and associated gallbladder stones: surgical aspects. Best Pract Res Clin Gastroenterol 20:1103–1116PubMedCrossRef
10.
11.
Alexakis N, Connor S (2012) Meta-analysis of one- vs. two-stage laparoscopic/endoscopic management of common bile duct stones. HPB (Oxf) 14:254–259CrossRef
12.
Lu J, Cheng Y, Xiong XZ, Lin YX, Wu SJ, Cheng NS (2012) Two-stage vs single-stage management for concomitant gallstones and common bile duct stones. World J Gastroenterol 18:3156–3166PubMedCentralPubMedCrossRef
13.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 21(339):b2535. doi:10.​1136/​bmj.​b2535 CrossRef
14.
15.
Rhodes M, Sussman L, Cohen L, Lewis MP (1998) Randomised trial of laparoscopic exploration of common bile duct versus postoperative endoscopic retrograde cholangiography for common bile duct stones. Lancet 351:159–161PubMedCrossRef
16.
Nathanson LK, O’Rourke NA, Martin IJ, Fielding GA, Cowen AE, Roberts RK, Kendall BJ, Kerlin P, Devereux BM (2005) Postoperative ERCP versus laparoscopic choledochotomy for clearance of selected bile duct calculi: a randomized trial. Ann Surg 242:188–192PubMedCentralPubMedCrossRef
17.
Cuschieri A, Lezoche E, Morino M, Croce E, Lacy A, Toouli J, Faggioni A, Ribeiro VM, Jakimowicz J, Visa J, Hanna GB (1999) E.A.E.S. multicenter prospective randomized trial comparing two-stage vs single-stage management of patients with gallstone disease and ductal calculi. Surg Endosc 13:952–957PubMedCrossRef
18.
Sgourakis G, Karaliotas K (2002) Laparoscopic common bile duct exploration and cholecystectomy versus endoscopic stone extraction and laparoscopic cholecystectomy for choledocholithiasis. A prospective randomized study. Minerva Chir 57:467–474PubMed
19.
Noble H, Tranter S, Chesworth T, Norton S, Thompson M (2009) A randomized, clinical trial to compare endoscopic sphincterotomy and subsequent laparoscopic cholecystectomy with primary laparoscopic bile duct exploration during cholecystectomy in higher risk patients with choledocholithiasis. J Laparoendosc Adv Surg Tech A 19:713–720PubMedCrossRef
20.
Rogers SJ, Cello JP, Horn JK, Siperstein AE, Schecter WP, Campbell AR, Mackersie RC, Rodas A, Kreuwel HT, Harris HW (2010) Prospective randomized trial of LC + LCBDE vs ERCP/S + LC for common bile duct stone disease. Arch Surg 145:28–33PubMed
21.
Bansal VK, Misra MC, Garg P, Prabhu M (2010) A prospective randomized trial comparing two-stage versus single-stage management of patients with gallstone disease and common bile duct stones. Surg Endosc 24:1986–1989PubMedCrossRef
22.
ElGeidie AA, ElShobary MM, Naeem YM (2011) Laparoscopic exploration versus intraoperative endoscopic sphincterotomy for common bile duct stones: a prospective randomized trial. Dig Surg 28:424–431PubMedCrossRef
23.
Hong DF, Xin Y, Chen DW (2006) Comparison of laparoscopic cholecystectomy combined with intraoperative endoscopic sphincterotomy and laparoscopic exploration of the common bile duct for cholecystocholedocholithiasis. Surg Endosc 20:424–427PubMedCrossRef
24.
Ponsky JL, Heniford BT, Gersin K (2000) Choledocholithiasis: evolving intraoperative strategies. Am Surg 66:262–268PubMed
25.
Sharma A, Dahiya P, Khullar R, Soni V, Baijal M, Chowbey K (2012) Management of common bile duct stones in the laparoscopic era. Indian J Surg 74:264–269PubMedCentralPubMedCrossRef
26.
27.
Paganini AM, Guerrieri M, Sarnari J, De Sanctis A, D’Ambrosio G, Lezoche G, Lezoche E (2005) Long-term results after laparoscopic transverse choledochotomy for common bile duct stones. Surg Endosc 19:705–709PubMedCrossRef
28.
Coppola R, Riccioni ME, Ciletti S, Cosentino L, Ripetti V, Magistrelli P, Picciocchi A (2001) Selective use of endoscopic retrograde cholangiopancreatography to facilitate laparoscopic cholecystectomy without cholangiography. A review of 1139 consecutive cases. Surg Endosc 15:1213–1216PubMedCrossRef
29.
Lakatos L, Mester G, Reti G, Nagy A, Lakatos PL (2004) Selection criteria for preoperative endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy and endoscopic treatment of bile duct stones: results of a retrospective, single center study between 1996–2002. World J Gastroenterol 10:3495–3499PubMed
30.
Barr LL, Frame BC, Coulanjon A (1999) Proposed criteria for preoperative endoscopic retrograde cholangiography in candidates for laparoscopic cholecystectomy. Surg Endosc 13:778–781PubMedCrossRef
31.
Glomsaker T, Søreide K, Hoff G, Aabakken L, Søreide JA, Norwegian Gastronet ERCP Group (2011) Contemporary use of endoscopic retrograde cholangiopancreatography (ERCP): a Norwegian prospective, multicenter study. Scand J Gastroenterol 46:1144–1151PubMedCrossRef
32.
Mercer S, Singh S, Paterson I (2007) Selective MRCP in the management of suspected common bile duct stones. HPB (Oxf) 9:125–130CrossRef
33.
Freitas ML, Bell RL, Duffy AJ (2006) Choledocholithiasis: evolving standards for diagnosis and management. World J Gastroenterol 12:3162–3167PubMed
34.
Vandervoort J, Soetikno RM, Tham TC et al (2002) Risk factors for complications after performance of ERCP. Gastrointest Endosc 56:652–656PubMedCrossRef
35.
Salminen P, Laine S, Gullichsen R (2008) Severe and fatal complications after ERCP: analysis of 2555 procedures in a single experienced center. Surg Endosc 22:1965–1970PubMedCrossRef
36.
Tranter SE, Thompson MH (2002) Comparison of endoscopic sphincterotomy and laparoscopic exploration of the common bile duct. Br J Surg 89:1495–1504PubMedCrossRef
37.
Reinders JS, Kortram K, Vlaminckx B, van Ramshorst B, Gouma DJ, Boerma D (2011) Incidence of bactobilia increases over time after endoscopic sphincterotomy. Dig Surg 28:288–292PubMedCrossRef
38.
Bergman JJ, van der Mey S, Rauws EA, Tijssen JG, Gouma DJ, Tytgat GN, Huibregtse K (1996) Long-term follow-up after endoscopic sphincterotomy for bile duct stones in patients younger than 60 years of age. Gastrointest Endosc 6:643–649CrossRef
39.
Eleftheriadis E, Tzioufa V, Kotzampassi K, Aletras H (1988) Common bile-duct mucosa in choledochoduodenostomy patients: histological and histochemical study. HPB Surg 1:15–20PubMedCentralPubMedCrossRef
40.
Tzovaras G, Baloyiannis I, Zachari E, Symeonidis D, Zacharoulis D, Kapsoritakis A, Paroutoglou G, Potamianos S (2012) Laparoendoscopic rendezvous versus preoperative ERCP and laparoscopic cholecystectomy for the management of cholecysto-choledocholithiasis: interim analysis of a controlled randomized trial. Ann Surg 255:435–439PubMedCrossRef
41.
Morino M, Baracchi F, Miglietta C, Furlan N, Ragona R, Garbarini A (2006) Preoperative endoscopic sphincterotomy versus laparoendoscopic rendezvous in patients with gallbladder and bile duct stones. Ann Surg 244:889–893 (discussion 893–896)PubMedCentralPubMedCrossRef
42.
Gurusamy K, Sahay SJ, Burroughs AK, Davidson BR (2011) Systematic review and meta-analysis of intraoperative versus preoperative endoscopic sphincterotomy in patients with gallbladder and suspected common bile duct stones. Br J Surg 98:908–916PubMedCrossRef
43.
Wang B, Guo Z, Liu Z, Wang Y, Si Y, Zhu Y, Jin M (2013) Preoperative versus intraoperative endoscopic sphincterotomy in patients with gallbladder and suspected common bile duct stones: system review and meta-analysis. Surg Endosc 27(7):2454–2465PubMedCrossRef
44.
Sajid MS, Leaver C, Haider Z, Worthington T, Karanjia N, Singh KK (2012) Routine on-table cholangiography during cholecystectomy: a systematic review. Ann R Coll Surg Engl 94:375–380PubMedCentralPubMedCrossRef
45.
Ford JA, Soop M, Du J, Loveday BP, Rodgers M (2012) Systematic review of intraoperative cholangiography in cholecystectomy. Br J Surg 99:160–167PubMedCrossRef
46.
Metcalfe MS, Ong T, Bruening MH, Iswariah H, Wemyss-Holden SA, Maddern GJ (2004) Is laparoscopic intraoperative cholangiogram a matter of routine? Am J Surg 187:475–481PubMedCrossRef
47.
Buddingh KT, Nieuwenhuijs VB, van Buuren L, Hulscher JB, de Jong JS, van Dam GM (2011) Intraoperative assessment of biliary anatomy for prevention of bile duct injury: a review of current and future patient safety interventions. Surg Endosc 25:2449–2461PubMedCentralPubMedCrossRef
48.
Buddingh KT, Bosma BM, Samaniego-Cameron B, Ten Cate Hoedemaker HO, Hofker HS, van Dam GM, Ploeg RJ, Nieuwenhuijs VB (2013) Kumar versus Olsen cannulation technique for intraoperative cholangiography: a randomized trial. Surg Endosc 27:957–963PubMedCrossRef
Metadaten
Titel
Transcystic or Transductal Stone Extraction during Single-Stage Treatment of Choledochocystolithiasis: A Systematic Review
verfasst von
Jan Siert K. Reinders
Dirk J. Gouma
Dirk T. Ubbink
Bert van Ramshorst
Djamila Boerma
Publikationsdatum
01.09.2014
Verlag
Springer US
Erschienen in
World Journal of Surgery / Ausgabe 9/2014
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2537-8

Weitere Artikel der Ausgabe 9/2014

World Journal of Surgery 9/2014 Zur Ausgabe

OriginalPaper

Papillary Thyroid Microcarcinoma: An Over-Treated Malignancy?

OriginalPaper

Antiviral Therapy Decreases Recurrence of Hepatitis B Virus-related Hepatocellular Carcinoma after Curative Resection: A Meta-analysis

OriginalPaper

Postoperative Nonsteroidal Anti-inflammatory Drugs and Risk of Anastomotic Leak: Meta-analysis of Clinical and Experimental Studies

OriginalPaper

Correlation between Preoperative Imaging and Intraoperative Risk Assessment in the Prediction of Postoperative Pancreatic Fistula Following Pancreatoduodenectomy

OriginalPaper

A Modification of Radical Antegrade Modular Pancreatosplenectomy for Adenocarcinoma of the Left Pancreas: Significance of En Bloc Resection Including the Anterior Renal Fascia

OriginalPaper

Preoperative Hepatitis B Virus DNA Level is a Risk Factor for Postoperative Liver Failure in Patients Who Underwent Partial Hepatectomy for Hepatitis B-Related Hepatocellular Carcinoma

Neu im Fachgebiet Chirurgie

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.
Bildnachweise