Index Admission Emergency Laparoscopic Cholecystectomy and Common Bile Duct Exploration: Results From a Specialist Center in the United Kingdom

• Published in: Surgical laparoscopy, endoscopy & percutaneous techniques Vol. 29; no. 2; pp. 113 - 116
• Main Authors: Deytrikh, Andrew, Stewart, Sabrina, Malone, Nicholas, McTaggart, Eleanor, Leeder, Paul, Bhatti, Imran, Awan, Altaf
• Format: Journal Article
• Language: English
• Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-04-2019
• ISSN: 1530-4515; 1534-4908
• DOI: 10.1097/SLE.0000000000000602

BACKGROUND:The incidence of common bile duct (CBD) stones is between 10% to 18% in people undergoing cholecystectomy for gallstones. Laparoscopic exploration of the CBD is now becoming routine practice in the elective setting, however its safety and efficacy in emergencies is poorly understood.
METHODS:We analyzed our results for index emergency admission laparoscopic cholecystectomy within a specialist center in the United Kingdom. Data from all emergency cholecystectomies in our unit, between 2011 to 2016 were collected and analyzed retrospectively.
RESULTS:In total, 494 patients underwent emergency laparoscopic cholecystectomy; 53 (10.7%) patients underwent common bile duct exploration (CBDE), with 1 conversion and 1 bile leak. Indications for CBDE were based on preoperative imaging (41 cases, 81%) or intra-operative cholangiogram (44 cases, 83%) findings.
CONCLUSIONS:Index admission laparoscopic cholecystectomy and concomitant CBDE is safe and should be the gold standard treatment for patients presenting with acute biliary complications, reducing readmissions and the need for a 2-stage procedure.