liver-2018-posters-accepted-abstracts

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Journal of Gastroenterology and Digestive Diseases | Volume 3

May 25-26, 2018 | New York, USA

World Liver Conference 2018

holelithiasis and choledocholithiasis is a disease

where incidence increases with age and can have

serious complications such as pancreatitis, cholangitis

and liver abscesses, but its management is controversial,

because there are minimally invasive laparoscopic and

endoscopic surgical procedures. The best method for the

diagnosis of choledocholithiasis is magnetic resonance

cholangiopancreatography, which shows a sensitivity of

95%, is not invasive, does not use ionizing radiation, and is

of low risk to the patient. Its accuracy for the diagnosis of

choledocholithiasis is similar to that of endoscopic retrograde

cholangiopancreatography (ERCP) or transparietohepatic

cholangiography, without the risks associated with these

invasive procedures. Endoscopic treatment is indicated

during the perioperative period or during cholecystectomy,

while surgical treatment consists of exploration of the

cystic duct or classical choledochotomy, and also during

laparoscopic or robotic cholecystectomy. The time of

diagnosis of choledocholithiasis is important to establish

the type of treatment. Bile duct exploration through the

laparoscopic access has been suggested as the gold standard

for the treatment of choledocholithiasis, including robotic

surgery, by some authors. The access to the biliary tract

can be obtained through the cystic or common bile duct.

In our service, patients with few stones in the bile duct, in

a distal position, colecystectomized, with high anesthetic

or surgical risk, with sickle cell anemia, severe obese and

with suppurative acute cholangitis are submitted to ERCP.

And the other hand, patients submitted to Gastric Bypass

or Gastrectomy with BII or Y-Roux reconstruction, with a

disproportionate caliber of the distal choledochus in relation

to the stones, with multiple or proximal choledocholithiasis

andwhenERCP faultor isnot available, aresubmittedtobiliary

whitening through choledochotomy. Therefore, I would like

to reveal our protocol to approach coledocholitiasis as well

as demonstrate our step-by-step procedure for the main

biliary tract in these cases, presenting our results.

Is ERCP the best treatment for coledocholithiasis? Laparoscopic and robotic management in

choledocholithiasis

Maxwel Capsy Boga Ribeiro

Federal University of Uberlândia, Brazil