지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2008.9
- 수록면
- 191 - 194 (4page)
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초록· 키워드
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Purpose: With the advent of endoscopic technology, ERCP (endoscopic retrograde cholangiopancreatography)/ES (endoscopic sphincterotomy) has become the main treatment for CBD stones. However, when ERCP fails to remove CBD stones, it remains unclear whether laparoscopic treatment is an alternative or not. The aim of this study was to investigate the outcome of LCBDE for the management of difficult choledocholithiasis.
Methods: This study was a retrospective analysis of 68 LCBDE cases that were performed at the Ewha Womans University School of Medicine, Mokdong Hospital from January, 2000 to March, 2006. Group A was defined that primary LCBDE was performed without ERCP/ES. Group B was defined that secondary LCBDE was performed after ERCP/ES had failed. The operative outcomes and postoperative complications were compared between the two groups.
Results: Primary LCBDE was performed for 33 patients (Group A) and secondary LCBDE after failure of ERCP/ES was performed for 35 patients (Group B). No significant differences in gender, mean age and associated diseases were noted between the two groups. The stone clearance rate was 100% for both groups. There were no significant differences between the two groups for the mean operative time (201.5 min for Group A vs 188.7 min for Group B: P=0.415), the open conversion rate (9.1% vs 0%, respectively: P=0.068), the complication rate (12.1% vs 8.6%, respectively: P=0.630) and the duration of the hospital stay (14.3 days vs 11.9 days, respectively: P=0.169). The recurrence rate along with a mean follow-up of 24 months showed no significant difference between the two groups (12.1% vs 2.9%, respectively).
Conclusion: When ERCP is impossible or stone retrieval is incomplete, LCBDE is an alternative treatment for difficult CBD stones.
Methods: This study was a retrospective analysis of 68 LCBDE cases that were performed at the Ewha Womans University School of Medicine, Mokdong Hospital from January, 2000 to March, 2006. Group A was defined that primary LCBDE was performed without ERCP/ES. Group B was defined that secondary LCBDE was performed after ERCP/ES had failed. The operative outcomes and postoperative complications were compared between the two groups.
Results: Primary LCBDE was performed for 33 patients (Group A) and secondary LCBDE after failure of ERCP/ES was performed for 35 patients (Group B). No significant differences in gender, mean age and associated diseases were noted between the two groups. The stone clearance rate was 100% for both groups. There were no significant differences between the two groups for the mean operative time (201.5 min for Group A vs 188.7 min for Group B: P=0.415), the open conversion rate (9.1% vs 0%, respectively: P=0.068), the complication rate (12.1% vs 8.6%, respectively: P=0.630) and the duration of the hospital stay (14.3 days vs 11.9 days, respectively: P=0.169). The recurrence rate along with a mean follow-up of 24 months showed no significant difference between the two groups (12.1% vs 2.9%, respectively).
Conclusion: When ERCP is impossible or stone retrieval is incomplete, LCBDE is an alternative treatment for difficult CBD stones.
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REFERENCES
참고문헌 (16)
참고문헌 신청
1. [학술지(정기간행물)] - Tang CN / 2005 / Technical aspects in the laparoscopic management of complicated common bile duct stones / J Hepatobiliary Pancreat Surg 12 : 444 ~ 450
2. [학술지(정기간행물)] - Tai CK / 2004 / Laparoscopic exploration of common bile duct in difficult choledocholithiasis / Surg Endosc 18 : 710 ~ 714
3. [학술지(정기간행물)] - Fan ST / 1993 / Early treatment of acute biliary pancreatitis by endoscopic papillotomy / N Engl J Med 328 : 228 ~ 232
4. [학술지(정기간행물)] - Lai EC / 1992 / Endoscopic biliary drainage for severe acute cholangitis / N Engl J Med 326 : 1582 ~ 1586
5. [학술지(정기간행물)] - Neoptolemos JP / 1988 / Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones / Lancet 2 : 979 ~ 983
2. [학술지(정기간행물)] - Tai CK / 2004 / Laparoscopic exploration of common bile duct in difficult choledocholithiasis / Surg Endosc 18 : 710 ~ 714
3. [학술지(정기간행물)] - Fan ST / 1993 / Early treatment of acute biliary pancreatitis by endoscopic papillotomy / N Engl J Med 328 : 228 ~ 232
4. [학술지(정기간행물)] - Lai EC / 1992 / Endoscopic biliary drainage for severe acute cholangitis / N Engl J Med 326 : 1582 ~ 1586
5. [학술지(정기간행물)] - Neoptolemos JP / 1988 / Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones / Lancet 2 : 979 ~ 983
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UCI(KEPA) : I410-ECN-0101-2013-514-002689998