Laparoscopic bile duct exploration under fluoroscopic guidance. Analysis after two years of experience

Abstract

Objective: To describe the experience in the laparoscopic bile duct exploration under fluoroscopic guidance in the Hospital
Universitario de Caracas. Method: A longitudinal, prospective, descriptive study of nine emergency room patients in our hospital that was admitted with an indication of bile duct exploration in a two year period (February 2005 – February 2007).
Results: The mean age was 45 years (29-78), The technique was 66,7% successful and the transcystic approach with efficacy
of 44,5% was the first choice, the remaining cases were treated by choledochotomy. The mean operative time of the transcystic
exploration was 102 minutes and 210 minutes for the transcholedocal approach. We converted three cases to open surgery due
to impacted stones. There was just one case of postoperative diarrhea, no other complication was reported. The mean hospital
stay was 2 days for the transcystic approach and 4 days for trasncholedochal. No cases of retained stones were reported.
Conclusions: The laparoscopic bile duct exploration under fluoroscopic guidance is a safe and effective technique with minimal morbidity, and offers the known benefits of minimally invasive surgery.