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Intraoperative Endoscopist-Controlled Guide Wire Cannulation Technique Sphincterotomy During Laparoscopic Cholecystectomy.
MedLine Citation:
PMID:  22957925     Owner:  NLM     Status:  Publisher    
Abstract Background: Intraoperative endoscopic sphincterotomy (IOES) is considered superior to preoperative endoscopic sphincterotomy and other treatment modalities for management of common bile duct (CBD) stones. Here we describe the method and results of our technique of IOES in the supine position during laparoscopic cholecystectomy (LC) using a guide wire cannulation (intraoperative supine endoscopic sphincterotomy by endoscopist-controlled guide wire cannulation) [ISEEG] technique). Patients and Methods: This is a retrospective analysis of the outcome for 36 patients undergoing LC with IOES (ISEEG technique) for acute biliary colic and jaundice with suspicion of choledocholithiasis. Results: On confirmation of CBD stones by intraoperative cholangiogram, CBD catheterization was successful in 34/36 (94.44%) patients with successful stone clearance in all of them by the ISEEG technique demonstrating 100% efficacy for stone clearance; the remaining 2 patients needed conversion to open surgery. The median time for the ISEEG technique during intraoperative sphincterotomy was 9 minutes (range, 7-23 minutes). Average hospital stay was 4.8 days (range, 2-15 days). At the 1-month follow-up, all patients were biliary symptom-free. Three of 36 patients (8.33%) had mild postoperative pancreatitis. There was no procedure-related mortality. Conclusions: LC coupled with the ISEEG technique performed by an expert endoscopist is an effective single-stage minimally invasive treatment for CBD stones with good efficacy, good stone clearance rates, and low morbidity.
Gianfranco Donatelli; Parag Dhumane; Bernard Dallemagne; Silvana Perretta; Didier Mutter; Michel Delvaux; Michel Doffoel; Gerard Gay; Jacques Marescaux
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-7
Journal Detail:
Title:  Journal of laparoendoscopic & advanced surgical techniques. Part A     Volume:  -     ISSN:  1557-9034     ISO Abbreviation:  J Laparoendosc Adv Surg Tech A     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706293     Medline TA:  J Laparoendosc Adv Surg Tech A     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 Research Institute Against Digestive Cancer/European Institute of TeleSurgery, Department of Gastrointestinal and Endocrinal Surgery, University of Strasbourg , Strasbourg, France .
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