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• W2013990197 abstract "In this issue of JMAS, the article by Bandyopadhyay, which are raised by the present publication in JMAS. et al. on ‘Antegrade common bile duct (CBD) stenting The important issues regarding the laparoscopic after laparoscopic CBD exploration’ [1] makes surgical management of ductal calculi include: (i) interesting reading in addition to raising certain technique of ductal clearance, (ii) need for drainage of unsettled issues concerning this laparoscopic CBD and if so, the best method to achieve this, and procedure. In the first instance, the authors are to be (iii) indications for internal bilio-enteric drainage complemented for the excellent clinical outcome of (choledochoduodenostomy/choledochojejunostomy). their patients treated for ductal calculi with no mortality and a morbidity approximating 6%, which TECHNIQUES OF LAPAROSCOPIC DUCTAL is well below that reported in most published series. CLEARANCE Another aspect of the series, which is most interesting The authors of the present series dismiss completely is the low negative endoscopic retrograde trans-cystic duct exploration and indicate that direct cholangiopancreatography (ERCP) rate, 16/316 supraduodenal CBD exploration is preferred in their patients (5%) contrasting with the reported negative institution as it is more reliable. On the basis of my rates varying from 20 to 50%. It is obvious that the own experience and published evidence. authors have very effective protocols for the selection have to disagree with this. In the first instance, of patients requiring ERCP. laparoscopic trans-cystic ductal clearance is infinitely less traumatic than supraduodenal choledochotomy, There is good evidence from one large multi-centre i.e., it leaves the entire extrahepatic biliary tract in its RCT and a smaller single-centre RCT together with pristine state and for this reason, recovery from this many large non-randomized series that single stage procedure is almost identical to that of LC alone. It is laparoscopic treatment for patients with symptomatic applicable to about 60% of cases. The size of stone(s) gallstones and ductal calculi is as safe and as effective which can be extracted through the cystic duct as two-stage treatment (endoscopic stone extraction obviously depends on the size of the cystic duct; followed by laparoscopic cholecystectomy), but it although some actually balloon dilate the duct, a I would" @default.
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• W2013990197 date "2007-01-01" @default.
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• W2013990197 title "Laparoscopic bile duct surgery: Home truths" @default.
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• W2013990197 doi "https://doi.org/10.4103/0972-9941.30678" @default.
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