Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

Author:

Shojaiefard Abolfazl1,Esmaeilzadeh Majid2,Ghafouri Ali1,Mehrabi Arianeb2

Affiliation:

1. Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

2. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, 69120 Heidelberg, Germany

Abstract

Common bile duct stones (CBDSs) may occur in up to 3%–14.7% of all patients for whom cholecystectomy is preformed. Patients presenting with CBDS have symptoms including: biliary colic, jaundice, cholangitis, pancreatitis or may be asymptomatic. It is important to distinguish between primary and secondary stones, because the treatment approach varies. Stones found before, during, and after cholecystectomy had also differing treatments. Different methods have been used for the treatment of CBDS but the suitable therapy depends on conditions such as patient' satisfaction, number and size of stones, and the surgeons experience in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD exploration (transcystic or transcholedochal), or laparotomy with CBD exploration (by T-tube, C-tube insertion, or primary closure) are the most commonly used methods managing CBDS. We will review the pathophysiology of CBDS, diagnosis, and different techniques of treatment with especial focus on the various surgical modalities.

Publisher

Hindawi Limited

Subject

Gastroenterology,Hepatology

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