dc.contributor.author | Conlon, Kevin | en |
dc.contributor.author | O'Connor, Donal | en |
dc.date.accessioned | 2019-08-19T12:12:56Z | |
dc.date.available | 2019-08-19T12:12:56Z | |
dc.date.issued | 2019 | en |
dc.date.submitted | 2019 | en |
dc.identifier.citation | Memba, R., Gonz?lez, S., Coronado, D., (...), Conlon, K.C., Jorba, R., Single-stage approach for the management of choledocolithiasis with concomitant cholelithiasis. Implementation of a protocol in a secondary hospital, The Surgeon, 2019, 1-- | en |
dc.identifier.other | Y | en |
dc.identifier.uri | http://hdl.handle.net/2262/89225 | |
dc.description | IN_PRESS | en |
dc.description.abstract | Background: Current evidence shows that single-stage treatment of concomitant choledocholithiasis and cholelithiasis is as effective and safe as two-stage treatment. However, several studies suggest that single-stage approach requires shorter hospitalization time and is more cost-effective than the two-stage approach, even though it requires considerable training. This study aimed to evaluate the implementation of a protocol for managing concomitant choledocholithiasis and cholelithiasis using single-stage treatment. Methods: A prospective cohort study of patients diagnosed with cholelithiasis and chol-edocholithiasis who were treated with the single-stage treatmentetranscystic instru-mentation, choledocotomy or intraoperative endoscopic retrograde cholangiopancreatography (ERCP) -between September 2010 and June 2017 was assessed. The primary outcomes were complications, hospital stay, operative time and recurrence rate. Results: 164 patients were enrolled. 141 (86%) were operated laparoscopically. Preoperatively diagnosed stones were not found by intraoperative imaging or disappeared after “flushing” in 38 patients (23.2%). Surgical approach was transcystic in 45 patients (27.41%), choledochotomy in 74 (45.1%), intraoperative ERCP in 4 (2.4%), and bilioenteric derivation in 3 (1.8%). Mean hospitalization stay was 4.4 days. Mean operative time was 166 min 27 patients(16.5%) had complications and 1 patient was exitus (0.6%). Recurrence rate was 1.2%. Conclusions: Single-stage approach is a safe and effective management option forconcomitant cholelithiasis and choledocolithiasis. Furthermore, a significant number of common bile duct stones pass spontaneously to duodenum or can benefit from a trans-cystic approach, with presumable low morbidity and cost-efficiency. | en |
dc.format.extent | 1- | en |
dc.language.iso | en | en |
dc.relation.ispartofseries | The Surgeon | en |
dc.rights | Y | en |
dc.subject | Common bile duct stones | en |
dc.subject | Choledocholithiasis | en |
dc.subject | Single-stage treatment | en |
dc.subject | One-step treatment | en |
dc.subject | Transcystic approach | en |
dc.subject | Choledochotomy | en |
dc.subject | Concomitant choledocholithiasis | en |
dc.subject | Cholelithiasis | en |
dc.subject.lcsh | concomitant chol-edocholithiasis and cholelithiasis | en |
dc.title | Single-stage approach for the management of choledocolithiasis with concomitant cholelithiasis. Implementation of a protocol in a secondary hospital | en |
dc.type | Journal Article | en |
dc.type.supercollection | scholarly_publications | en |
dc.type.supercollection | refereed_publications | en |
dc.identifier.peoplefinderurl | http://people.tcd.ie/conlonk | en |
dc.identifier.peoplefinderurl | http://people.tcd.ie/oconnd15 | en |
dc.identifier.rssinternalid | 198968 | en |
dc.identifier.doi | https://doi.org/10.1016/j.surge.2018.12.001 | en |
dc.rights.ecaccessrights | openAccess | |
dc.identifier.orcid_id | 0000-0002-3703-7080 | en |
dc.status.accessible | N | en |