Safe laparoscopic clearance of the common bile duct in emergently admitted patients with choledocholithiasis and cholangitis

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dc.contributor.authorAtstupens, Kristaps
dc.contributor.authorPlaudis, Haralds
dc.contributor.authorFokins, Vladimirs
dc.contributor.authorMukans, Maksims
dc.contributor.authorPupelis, Guntars
dc.date.accessioned2022-02-26T20:30:01Z
dc.date.available2022-02-26T20:30:01Z
dc.date.issued2016
dc.description.abstractBackgrounds/Aims: Laparoscopic treatment of patients with choledocholithiasis and cholangitis is challenging due to mandatory recovery of the biliary drainage and clearance of the common bile duct (CBD). The aim of our study was to assess postoperative course of cholangitis and biliary sepsis after laparoscopic clearance of the CBD in emergently admitted patients with choledocholithiasis and cholangitis. Methods: Emergently admitted patients who underwent lapa-roscopic clearance of the CBD were included prospectively and stratified in 2 groups i.e., cholangitis positive (CH+) or negative (CH-) group. Patient demographics, comorbidities, preoperative imaging data, inflammatory response, surgi-cal intervention, complication rate and outcomes were compared between groups. Results: Ninety-nine of a total 320 patients underwent laparoscopic clearance of the CBD, of which, 60 belonged to the acute cholangitis group (CH+) and 39 to the cholangitis negative group (CH-). Interventions were done on average 4 days after admission, operation duration was 95-105 min, and the conversion rate was 3-7% without differences in the groups. Preoperative in-flammatory response was markedly higher in the CH+ group. Inflammation signs on intraoperative choledochoscopy were more evident in patients with cholangitis. Postoperative inflammatory response did not differ between the groups. The overall complication rate was 8.3% and 5.1%, respectively. Laparoscopic clearance of the CBD resulted in 1 lethal case (CH+ group), resulting in 1% mortality rate and a similar 12-month readmission rate. Conclusions: Single-stage laparoscopic intraoperative US and choledochoscopy-assisted clearance of the CBD is feasible in emergently admitted patients with choledocholithiasis and cholangitis. (Korean J Hepatobiliary Pancreat Surg 2016;20:53-60)en
dc.description.statusPeer reviewed
dc.format.extent8
dc.format.extent349329
dc.identifier.citationAtstupens, K, Plaudis, H, Fokins, V, Mukans, M & Pupelis, G 2016, 'Safe laparoscopic clearance of the common bile duct in emergently admitted patients with choledocholithiasis and cholangitis', Korean Journal of Hepato-Biliary-Pancreatic Surgery, vol. 20, no. 2, pp. 53-60. https://doi.org/10.14701/kjhbps.2016.20.2.53
dc.identifier.doi10.14701/kjhbps.2016.20.2.53
dc.identifier.issn1738-6349
dc.identifier.otherMendeley: 9d32ae07-1fca-3bfe-8003-087b3817ef69
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/7645
dc.identifier.urlhttps://www-webofscience-com.db.rsu.lv/wos/alldb/full-record/MEDLINE:27212991
dc.language.isoeng
dc.relation.ispartofKorean Journal of Hepato-Biliary-Pancreatic Surgery
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectSafe laparoscopic clearance of the common bile duct in emergently admitted patients with choledocholithiasis and cholangitis
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.titleSafe laparoscopic clearance of the common bile duct in emergently admitted patients with choledocholithiasis and cholangitisen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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