FOLLOW-UP OF 161 UNSELECTED CONSECUTIVE PATIENTS TREATED LAPAROSCOPICALLY FOR COMMON BILE-DUCT STONES

Background: Aim was to study the incidence of recurrent ductal stones and of biliary strictures at follow-up after laparoscopic treatment of gallstones and common bile duct stones and to update the short-term r esults. Methods: Ductal stones were proven in 161 patients of 1,975 (8 .1%) undergoing laparoscopic cholecystectomy. Laparoscopic transcystic CBD exploration was the method of choice. If this was unsuccessful, l aparoscopic choledochotomy was performed. After treatment, all patient s were enrolled in a continued, ongoing follow-up study. Results: Lapa roscopic CBD exploration was completed in 157 cases (transcystic 107, choledochotomy 50). Retained stones occurred in eight patients (5%) an d major complications (cystic duct leakage, hemoperitoneum) in six (3. 8%); mortality occurred in one high-risk patient (0.6%). Follow-up ava ilable in 154 patients (two unrelated deaths) for a period of up to 62 months showed the occurrence of recurrent ductal stones in five cases (3.2%) and no signs of bile stasis, suggestive of ductal stricture, o n the basis of clinical and laboratory findings. Conclusions: This pro spective, ongoing follow-up study demonstrates that laparoscopic treat ment of gallstones and common bile duct stones in unselected patients is feasible and safe.