Document Detail

Laparoscopic treatment of recurrent pyogenic cholangitis.
MedLine Citation:
PMID:  15995814     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/PURPOSE: We reviewed the selective use of hand-assisted laparoscopic segmentectomy (HALS) and laparoscopic choledochoduodenostomy (LCD) in the management of recurrent pyogenic cholangitis (RPC). METHODS: We carried out a retrospective review of a prospectively maintained database of laparoscopic treatment of RPC during the period 1995 to 2004. The perioperative data were analyzed. RESULTS: There were 33 laparoscopic procedures performed in 30 patients with RPC during the period 1995--2004. There were 23 female and 7 male patients, with a mean age of 63.2+/-14.9 years (range, 29--92 years). All these patients had a history of repeated attacks of cholangitis, and multiple sessions of endoscopic lithotripsy or operative retrieval had previously been attempted. Of these 33 procedures, there were 23 LCDs and 10 HALS. Three patients underwent simultaneous LCD and HALS in the same operation. The mean operative time was 172+/-63.5 min (range, 75--290 min) and there were three open conversions (10%), due to (1) intraoperative bleeding from the left hepatic vein, (2) lost broken tip of ultrasonic dissector, and (3) significant bleeding during choledochotomy, respectively. Average hospital stay was 11.4+/-11.1 days (range, 5--60 days). Eight complications (26.6%) were encountered, which included four bile leaks, three wound infections, and one intraabdominal collection. Complete stone clearance was achieved in all but 1 patient (rate, 96.6%), in whom the residual stones were extracted through a postoperative combined endoscopic and percutaneous approach. Long-term results were satisfactory, and only one stone recurrence was detected, upon a mean follow-up of 34.7 months (range, 1--107 months). CONCLUSIONS: Both LCD and HALS are safe, feasible, and effective treatments for patients with RPC.
Chung-Ngai Tang; Chi-Kin Tai; Wing-Tai Siu; Joe P Y Ha; Ka-Kin Tsui; Michael K W Li
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hepato-biliary-pancreatic surgery     Volume:  12     ISSN:  0944-1166     ISO Abbreviation:  J Hepatobiliary Pancreat Surg     Publication Date:  2005  
Date Detail:
Created Date:  2005-07-04     Completed Date:  2005-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431940     Medline TA:  J Hepatobiliary Pancreat Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  243-8     Citation Subset:  IM    
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong.
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MeSH Terms
Aged, 80 and over
Cholangitis / etiology,  surgery*
Choledochostomy / methods*
Cholelithiasis / complications,  surgery
Cholestasis / etiology,  surgery
Hepatectomy / methods*
Middle Aged
Recurrence / prevention & control
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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