surgery-anesthesia-euro-gastro-congress-2018-posters

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N o v e m b e r 1 2 - 1 3 , 2 0 1 8 | R o m e , I t a l y

Joint Event on

OF EXCELLENCE

IN INTERNATIONAL

MEETINGS

YEARS

Surgery and Anesthesia 2018 & Euro Gastro Congress 2018

Case Reports in Surgery and Invasive Procedures

Volume 2

GASTROENTEROLOGY

International Conference on

SURGERY AND ANESTHESIA

International Conference on

Case Rep Surg Invasive Proced 2018, Volume 2

SURGICAL (OPEN AND LAPAROSCOPIC) MANAGEMENT OF LARGE DIFFICULT

CBD STONES AFTER DIFFERENT SESSIONS OF ENDOSCOPIC FAILURE

Emad Hamdy Gad

National Liver Institute, Egypt

or complicated large difficult CBD stones that cannot be extracted by ERCP, patients can be managed safely by open or laparo-

scopic CBD exploration. The aim of this study was to assess these surgical procedures of CBDE after endoscopic failure.

Methods:

We retrospectively reviewed and analyzed 85 patients underwent surgical management of large difficult CBD stones after

ERCP failure, in the period from beginning of 2013 to beginning of 2018. The overall male/female ratio was 27/58.

Results:

Sixty seven (78.8%) and 18(21.2%) of our patients underwent single and multiple ERCP sessions respectively with signifi-

cant correlation between number of ERCP sessions and post ERCP complications (P=0.009). Impacted large stone was the most

frequent cause of ERCP failure (60%). LCBDE, OCBDE and the converted cases were 24.7% (n=21), 70.6% (n=60), and 4.7% (n= 4)

respectively. Stone clearance rate post LCBDE and OCBDE reached 95.2% and 95% respectively (P< 0.05), Eleven (12.9%) of our pa-

tients had post operative complications (14.3% post LCBDE and 11.7% post OCBDE, P<0.05) without mortality. By comparing LCB-

DE and OCBDE groups; there was significant association between the former and younger age, shorter referral time, more frequent

choledochoscopy, and longer operative time with independent correlation regarding age and operative time. On comparing, T-tube

and 1ry CBD closure in LCBDE group, there was significant longer operative time, and hospital stay in the former. However, on com-

paring them in OCBDE group, there was significant correlation between 1ry CBD closure and smaller diameter of CBD, single stone,

choledochoscopy, shorter operative times and hospital stays. Furthermore, in OCBDE group, choledocoscopy had independent

direction to 1ry CBD repair and significant association with shorter operative time, hospital stay, and higher stone clearance rate.