A. J. M. Campbell-Lloyd MB BS; D. J. Martin MB BS, FRACS; I. J. Martin MB BS, FRACS.
LONG-TERM OUTCOMES AFTER LAPAROSCOPIC BILE DUCT EXPLORATION: A 5-YEAR FOLLOW UP OF 150 CONSECUTIVE PATIENTS
Article first published online: 29 MAY 2008
© 2008 The Authors Journal compilation © 2008 Royal Australasian College of Surgeons
ANZ Journal of Surgery
Volume 78, Issue 6, pages 492–494, June 2008
How to Cite
Campbell-Lloyd, A. J. M., Martin, D. J. and Martin, I. J. (2008), LONG-TERM OUTCOMES AFTER LAPAROSCOPIC BILE DUCT EXPLORATION: A 5-YEAR FOLLOW UP OF 150 CONSECUTIVE PATIENTS. ANZ Journal of Surgery, 78: 492–494. doi: 10.1111/j.1445-2197.2008.04541.x
- Issue published online: 29 MAY 2008
- Article first published online: 29 MAY 2008
- Accepted for publication 24 September 2007.
- common bile duct;
- follow up;
- long-term effect;
Background: The treatment of common bile duct stones discovered at routine intraoperative cholangiography includes postoperative endoscopic retrograde cholangiography or intraoperative laparoscopic common bile duct exploration. Given the equivalence of short-term outcome data for these two techniques, the choice of one over the other may be influenced by long-term follow-up data. We aimed to establish the long-term outcomes following laparoscopic common bile duct exploration and compare this with endoscopic retrograde cholangiography.
Methods: One hundred and fifty consecutive patients underwent laparoscopic common bile duct exploration between March 1998 and March 2006 carried out by a single surgeon. All were prospectively studied for 1 month followed by a late-term phone questionnaire ascertaining the prevalence of adverse symptoms. Patients presented with a standardized series of questions, with reports of symptoms corroborated by review of medical records.
Results: In 150 patients, operations included laparoscopic transcystic exploration (135), choledochotomy (10) and choledochoduodenostomy (2). At long-term follow up (mean 63 months), 116 (77.3%) patients were traceable, with 24 (20.7%) reporting an episode of pain and 18 (15.5%) had more than a single episode of pain. There was no long-term evidence of cholangitis, stricture or pancreatitis identified in any patient.
Conclusion: Laparoscopic bile duct exploration appears not to increase the incidence of long-term adverse sequelae beyond the reported prevalence of postcholecystectomy symptoms. There was no incidence of bile duct stricture, cholangitis or pancreatitis. It is a safe procedure, which obviates the need and expense of preoperative or postoperative endoscopic retrograde cholangiography in most instances.