RESULTS OF THE ROUTINE USE OF A MODIFIED ENDOPROSTHESIS TO DRAIN THE COMMON BILE-DUCT AFTER LAPAROSCOPIC CHOLEDOCHOTOMY

Background: One hundred eighty-one patients were submitted to laparosc opic common bile duct exploration. Methods: A transcystic approach was used in 147 patients, choledochotomy in 14, and both in 20. The indic ations to perform a choledochotomy included stones larger than 20 mt, stones proximal to the cystic duct entrance, and cases in which the tr anscystic duct approach proved impossible or unsuccessful. Results: Th e common bile duct was drained by a T-tube in four patients, by laparo scopic sphincterotomy in one, by laparoscopic choledochoduodenostomy i n one, and by a 10 Fr endoprosthesis in 28. The stent placement was te chnically feasible in all patients but one. The biliary drainage was a dequate. Mean hospital stay was 2.1 days. Complication was limited to one umbilical infection and one self-limited biliary leak. Conclusions : The procedure proved to be technically simple, safe, and efficient, and resulted in a low morbidity rate and short hospital stay.