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The short- and long-term outcome after the surgical management of common bile duct stones in a tertiary referral hospital

BACKGROUND: The removal of common bile duct stones by endoscopic retrograde cholangiopancreatography (ERCP) shows excellent results with low complication rates and is therefore considered a gold standard. However, in case of stones non-removable by ERCP, surgical extraction is needed. The surgical a...

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Autores principales: Hess, Gabriel F., Sedlaczek, Philipp, Zeindler, Jasmin, Muenst, Simone, Schmitt, Andreas M., Däster, Silvio, Bolli, Martin, Kollmar, Otto, Soysal, Savas D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386922/
https://www.ncbi.nlm.nih.gov/pubmed/37515739
http://dx.doi.org/10.1007/s00423-023-03011-2
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author Hess, Gabriel F.
Sedlaczek, Philipp
Zeindler, Jasmin
Muenst, Simone
Schmitt, Andreas M.
Däster, Silvio
Bolli, Martin
Kollmar, Otto
Soysal, Savas D.
author_facet Hess, Gabriel F.
Sedlaczek, Philipp
Zeindler, Jasmin
Muenst, Simone
Schmitt, Andreas M.
Däster, Silvio
Bolli, Martin
Kollmar, Otto
Soysal, Savas D.
author_sort Hess, Gabriel F.
collection PubMed
description BACKGROUND: The removal of common bile duct stones by endoscopic retrograde cholangiopancreatography (ERCP) shows excellent results with low complication rates and is therefore considered a gold standard. However, in case of stones non-removable by ERCP, surgical extraction is needed. The surgical approach is still controversial and clinical guidelines are missing. This study aims to analyze the outcomes of patients treated with choledochotomy or hepaticojejunostomy for common bile duct stones. METHODS: All patients who underwent choledochotomy or hepaticojejunostomy for common bile duct stones at a tertiary referral hospital over 11 years were included. The analyzed data contains basic demographics, diagnostics, surgical parameters, length of hospitalization, and morbidity and mortality. RESULTS: Over the study period, 4375 patients underwent cholecystectomy, and 655 received an ERCP with stone extraction, with 48 of these patients receiving subsequent surgical treatment. ERCP was attempted in 23/30 (77%) of the choledochotomy patients pre/intraoperatively and 11/18 (56%) in hepaticojejunostomy patients. The 30-day major complication rate (Clavien-Dindo > II) was 1/30 (3%) in the choledochotomy group and 2/18 (11%) in the hepaticojejunostomy group. Complications after 30 days occurred in 3/30 (10%) patients and 2/18 (11%), respectively, and no mortality occurred. CONCLUSION: ERCP should still be considered the gold standard, although due to low short- and long-term morbidity rates, choledochotomy and hepaticojejunostomy represent effective surgical solutions for common bile duct stones. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00423-023-03011-2.
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spelling pubmed-103869222023-07-31 The short- and long-term outcome after the surgical management of common bile duct stones in a tertiary referral hospital Hess, Gabriel F. Sedlaczek, Philipp Zeindler, Jasmin Muenst, Simone Schmitt, Andreas M. Däster, Silvio Bolli, Martin Kollmar, Otto Soysal, Savas D. Langenbecks Arch Surg Research BACKGROUND: The removal of common bile duct stones by endoscopic retrograde cholangiopancreatography (ERCP) shows excellent results with low complication rates and is therefore considered a gold standard. However, in case of stones non-removable by ERCP, surgical extraction is needed. The surgical approach is still controversial and clinical guidelines are missing. This study aims to analyze the outcomes of patients treated with choledochotomy or hepaticojejunostomy for common bile duct stones. METHODS: All patients who underwent choledochotomy or hepaticojejunostomy for common bile duct stones at a tertiary referral hospital over 11 years were included. The analyzed data contains basic demographics, diagnostics, surgical parameters, length of hospitalization, and morbidity and mortality. RESULTS: Over the study period, 4375 patients underwent cholecystectomy, and 655 received an ERCP with stone extraction, with 48 of these patients receiving subsequent surgical treatment. ERCP was attempted in 23/30 (77%) of the choledochotomy patients pre/intraoperatively and 11/18 (56%) in hepaticojejunostomy patients. The 30-day major complication rate (Clavien-Dindo > II) was 1/30 (3%) in the choledochotomy group and 2/18 (11%) in the hepaticojejunostomy group. Complications after 30 days occurred in 3/30 (10%) patients and 2/18 (11%), respectively, and no mortality occurred. CONCLUSION: ERCP should still be considered the gold standard, although due to low short- and long-term morbidity rates, choledochotomy and hepaticojejunostomy represent effective surgical solutions for common bile duct stones. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00423-023-03011-2. Springer Berlin Heidelberg 2023-07-29 2023 /pmc/articles/PMC10386922/ /pubmed/37515739 http://dx.doi.org/10.1007/s00423-023-03011-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Hess, Gabriel F.
Sedlaczek, Philipp
Zeindler, Jasmin
Muenst, Simone
Schmitt, Andreas M.
Däster, Silvio
Bolli, Martin
Kollmar, Otto
Soysal, Savas D.
The short- and long-term outcome after the surgical management of common bile duct stones in a tertiary referral hospital
title The short- and long-term outcome after the surgical management of common bile duct stones in a tertiary referral hospital
title_full The short- and long-term outcome after the surgical management of common bile duct stones in a tertiary referral hospital
title_fullStr The short- and long-term outcome after the surgical management of common bile duct stones in a tertiary referral hospital
title_full_unstemmed The short- and long-term outcome after the surgical management of common bile duct stones in a tertiary referral hospital
title_short The short- and long-term outcome after the surgical management of common bile duct stones in a tertiary referral hospital
title_sort short- and long-term outcome after the surgical management of common bile duct stones in a tertiary referral hospital
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386922/
https://www.ncbi.nlm.nih.gov/pubmed/37515739
http://dx.doi.org/10.1007/s00423-023-03011-2
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