The approach to biliary tract stones in patients undergoing laparoscopic cholecystectomy is still debated, due partly to technical difficulties in laparoscopic surgery of the main bile duct and partly to lack of knowledge on long term prognosis of residual bile duct stones following operation. To elucidate this point, we followed up for 6-34 months 270 patients who underwent laparoscopic cholecystectomy. In 234 patients, we collected clinical, biochemical and ultrasonographic information, whereas in 34 a telephone interview was carried out 15-28 months postoperatively. During the follow-up period one patient developed complications due to residual bile duct stones, treated by endoscopic sphincterotomy and stone extraction. Our data suggest that the clinical incidence of residual bile duct stones following laparoscopic cholecystectomy is less than 1%. The natural history of silent bile duct stones may consists of spontaneous clearance rather than progression to bile duct obstruction. The most cost-effective approach to excluding bile duct stones in symptomatic gallstone patients undergoing laparoscopic cholecystectomy should consists of an accurate selection of patients in whom endoscopic retrograde cholangiography should be performed preoperatively, on the basis of specific clinical indication. Search for silent bile duct stones by other pre- or peri-operative techniques seems of little clinical relevance.
|Translated title of the contribution||Laparoscopic cholecystectomy and residual bile duct stones: A follow-up study|
|Number of pages||4|
|Journal||Giornale Italiano di Endoscopia Digestiva|
|Publication status||Published - 1996|
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