Abstract
Background: Laparoscopic common bile duct exploration has been reported to be highly successful and cost-effective. It remains unknown to what extent the procedure is used in routine surgical practice. Methods: We conducted a survey of general surgeons practicing in a rural area of the United States. The type of practice, laparoscopic training, performance of cholangiography, and preferred approach to choledocholithiasis were elicited. Results: Sixty-eight of 207 surveys (33%) were returned. Thirty respondents (45%) indicated that they perform laparoscopic common bile duct explorations. The likelihood of laparoscopic common bile duct exploration increased with a higher number of cholecystectomies per year (p < 0.05, chi-square) but was independent of training or routine cholangiography. The preferred approach to a patient with choledocholithiasis was endoscopic retrograde cholangiopancreatography (75%), followed by laparoscopic (21%) and open exploration (4%). Reasons for not performing laparoscopic exploration were time (58%), equipment (24%), good gastrointestinal backup (6%), reimbursement (3%), increased morbidity (1.5%), lack of skill (1.5%), and other/no reason (18%). Conclusion: Although 45% of practicing surgeons indicated that they perform laparoscopic common bile duct explorations, only 21% practiced it as their preferred approach. Time constraints and lack of equipment are the main factors preventing the application of the laparoscopic technique toward choledocholithiasis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 577-579 |
| Number of pages | 3 |
| Journal | Surgical Endoscopy and Other Interventional Techniques |
| Volume | 20 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2006 |
| Externally published | Yes |
Fingerprint
Keywords
- Choledocholithiasis
- Common bile duct exploration
- Endoscopic retrograde cholangiopancreatography
- Laparoscopy
ASJC Scopus subject areas
- Surgery
Cite this
Management of common bile duct stones in a rural area of the United States : Results of a survey. / Bingener, J.; Schwesinger, W. H.
In: Surgical Endoscopy and Other Interventional Techniques, Vol. 20, No. 4, 04.2006, p. 577-579.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Management of common bile duct stones in a rural area of the United States
T2 - Results of a survey
AU - Bingener, J.
AU - Schwesinger, W. H.
PY - 2006/4
Y1 - 2006/4
N2 - Background: Laparoscopic common bile duct exploration has been reported to be highly successful and cost-effective. It remains unknown to what extent the procedure is used in routine surgical practice. Methods: We conducted a survey of general surgeons practicing in a rural area of the United States. The type of practice, laparoscopic training, performance of cholangiography, and preferred approach to choledocholithiasis were elicited. Results: Sixty-eight of 207 surveys (33%) were returned. Thirty respondents (45%) indicated that they perform laparoscopic common bile duct explorations. The likelihood of laparoscopic common bile duct exploration increased with a higher number of cholecystectomies per year (p < 0.05, chi-square) but was independent of training or routine cholangiography. The preferred approach to a patient with choledocholithiasis was endoscopic retrograde cholangiopancreatography (75%), followed by laparoscopic (21%) and open exploration (4%). Reasons for not performing laparoscopic exploration were time (58%), equipment (24%), good gastrointestinal backup (6%), reimbursement (3%), increased morbidity (1.5%), lack of skill (1.5%), and other/no reason (18%). Conclusion: Although 45% of practicing surgeons indicated that they perform laparoscopic common bile duct explorations, only 21% practiced it as their preferred approach. Time constraints and lack of equipment are the main factors preventing the application of the laparoscopic technique toward choledocholithiasis.
AB - Background: Laparoscopic common bile duct exploration has been reported to be highly successful and cost-effective. It remains unknown to what extent the procedure is used in routine surgical practice. Methods: We conducted a survey of general surgeons practicing in a rural area of the United States. The type of practice, laparoscopic training, performance of cholangiography, and preferred approach to choledocholithiasis were elicited. Results: Sixty-eight of 207 surveys (33%) were returned. Thirty respondents (45%) indicated that they perform laparoscopic common bile duct explorations. The likelihood of laparoscopic common bile duct exploration increased with a higher number of cholecystectomies per year (p < 0.05, chi-square) but was independent of training or routine cholangiography. The preferred approach to a patient with choledocholithiasis was endoscopic retrograde cholangiopancreatography (75%), followed by laparoscopic (21%) and open exploration (4%). Reasons for not performing laparoscopic exploration were time (58%), equipment (24%), good gastrointestinal backup (6%), reimbursement (3%), increased morbidity (1.5%), lack of skill (1.5%), and other/no reason (18%). Conclusion: Although 45% of practicing surgeons indicated that they perform laparoscopic common bile duct explorations, only 21% practiced it as their preferred approach. Time constraints and lack of equipment are the main factors preventing the application of the laparoscopic technique toward choledocholithiasis.
KW - Choledocholithiasis
KW - Common bile duct exploration
KW - Endoscopic retrograde cholangiopancreatography
KW - Laparoscopy
UR - http://www.scopus.com/inward/record.url?scp=33645732070&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33645732070&partnerID=8YFLogxK
U2 - 10.1007/s00464-005-0322-3
DO - 10.1007/s00464-005-0322-3
M3 - Article
VL - 20
SP - 577
EP - 579
JO - Surgical Endoscopy
JF - Surgical Endoscopy
SN - 0930-2794
IS - 4
ER -