A PHP Error was encountered

Severity: Warning

Message: file_get_contents(https://...@gmail.com&api_key=61f08fa0b96a73de8c900d749fcb997acc09): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests

Filename: helpers/my_audit_helper.php

Line Number: 143

Backtrace:

File: /var/www/html/application/helpers/my_audit_helper.php
Line: 143
Function: file_get_contents

File: /var/www/html/application/helpers/my_audit_helper.php
Line: 209
Function: simplexml_load_file_from_url

File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3098
Function: getPubMedXML

File: /var/www/html/application/controllers/Detail.php
Line: 574
Function: pubMedSearch_Global

File: /var/www/html/application/controllers/Detail.php
Line: 488
Function: pubMedGetRelatedKeyword

File: /var/www/html/index.php
Line: 316
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: Attempt to read property "Count" on bool

Filename: helpers/my_audit_helper.php

Line Number: 3100

Backtrace:

File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3100
Function: _error_handler

File: /var/www/html/application/controllers/Detail.php
Line: 574
Function: pubMedSearch_Global

File: /var/www/html/application/controllers/Detail.php
Line: 488
Function: pubMedGetRelatedKeyword

File: /var/www/html/index.php
Line: 316
Function: require_once

Lessons learned from implementing laparoscopic common bile duct exploration at a safety net hospital. | LitMetric

AI Article Synopsis

  • A study was conducted to compare two surgical approaches for treating choledocholithiasis (bile duct stones): laparoscopic cholecystectomy with common bile duct exploration and endoscopic retrograde cholangiopancreatography with cholecystectomy.
  • The research analyzed data from 179 patients, revealing that the laparoscopic approach had a 74.2% success rate, shorter hospital stays, and fewer readmissions compared to the endoscopic method.
  • Despite the advantages, laparoscopic cholecystectomy with common bile duct exploration is still not widely utilized, highlighting a gap in its adoption despite encouraging outcomes.*

Article Abstract

Background: Mounting evidence favors one-stage laparoscopic cholecystectomy with common bile duct exploration over endoscopic retrograde cholangiopancreatography with cholecystectomy for choledocholithiasis. However, laparoscopic cholecystectomy with common bile duct exploration remains underused. In 2020, our center initiated a laparoscopic cholecystectomy with common bile duct exploration program for choledocholithiasis. This study compares the experience and outcomes of laparoscopic cholecystectomy with common bile duct exploration compared with endoscopic retrograde cholangiopancreatography with cholecystectomy at a safety net hospital.

Methods: This single-center, retrospective study analyzed data from 179 patients admitted with choledocholithiasis from 2019 to 2023. Demographics, preoperative investigations, intraoperative details, and postoperative outcomes were evaluated.

Results: The study included 179 patients (55.6 ± 21.0 years, 66% female) with American Society of Anesthesiologists Physical Status Classification System score III (II-III) and body mass index 29 kg/m (25.8-35.5 kg/m). Of these, 148 underwent endoscopic retrograde cholangiopancreatography with cholecystectomy and 31 underwent laparoscopic cholecystectomy with common bile duct exploration. Demographic and preoperative data were similar between groups. Laparoscopic cholecystectomy with common bile duct exploration achieved a 74.2% success rate. Laparoscopic cholecystectomy with common bile duct exploration's average operative time was 180 (139-213) minutes, with a 3.2% postoperative bile leak and 35.4% requiring postoperative ERCP. Median lengths of stay were 3 (1-4) for laparoscopic cholecystectomy with common bile duct exploration and 4 days (3-7) for endoscopic retrograde cholangiopancreatography with cholecystectomy (Z = -3.16, P = .002). The number of readmissions were 1.2 ± 0.4 for laparoscopic cholecystectomy with common bile duct exploration and 1.9 ± 1.3 for endoscopic retrograde cholangiopancreatography with cholecystectomy (t = 1.43, P = .08). Additional procedures for choledocholithiasis were performed in 36% of laparoscopic cholecystectomy with common bile duct exploration and 79% of ERCP + LC cases (χ = 21.7, P < .0001).

Conclusion: The study highlights challenges in implementing laparoscopic cholecystectomy with common bile duct exploration at a safety net hospital. Results support laparoscopic cholecystectomy with common bile duct exploration over endoscopic retrograde cholangiopancreatography, with cholecystectomy, with shorter stays, fewer readmissions, and fewer additional procedures reported. Laparoscopic cholecystectomy with common bile duct exploration remains underused, with only 17.3% of patients who underwent one-stage laparoscopic cholecystectomy with common bile duct exploration. Further research is needed for laparoscopic cholecystectomy with common bile duct exploration's expansion as the superior choledocholithiasis treatment.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.surg.2024.07.088DOI Listing

Publication Analysis

Top Keywords

common bile
64
bile duct
64
laparoscopic cholecystectomy
60
cholecystectomy common
60
duct exploration
56
endoscopic retrograde
24
retrograde cholangiopancreatography
24
cholangiopancreatography cholecystectomy
24
cholecystectomy
21
bile
17

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!