Publication:

A prospective review of laparoscopic common bile duct exploration with nephroscope and primary closure without T tube

Background Here we present a pioneering laparoscopic method for common bile duct (CBD) stone management, evaluating its practicality, safety, and effectiveness when employing a nephroscope and omitting the placement of a T tube.

Methods We have prospectively collected data from 100 patients who underwent exclusive CBD laparoscopic CBD exploration (LCBDE) along with/without laparoscopic cholecystectomy diagnosed to have Cholelithiasis with choledocholithiasis with a radiological CBD diameter of 10mm or more. Mortality, morbidity, hospital stay, and average duration of hospital stay were all assessed.

Results In this prospective series 100 patients underwent the procedure, of which we had no mortality, of the 100 patients, 4 patients (4%) had bile leak i.e., bile output of more than 100 ml n drain, and 2 patients (2%) needed endoscopic retrograde cholangiopancreatography (ERCP) and stenting. The other 2 patient’s leak settled by itself without any interventions. One patient (1%) was diagnosed to have sepsis post LCBDE which also required a prolonged stay of 7 days for antibiotics.

Conclusions LCBDE offers good clinical outcomes in dealing with CBD stones. Surgeons experienced in laparoscopy can perform this procedure securely and efficiently.