Management of common bile duct stones in a rural area of the United States: Results of a survey

J. Bingener, W. H. Schwesinger

Research output: Contribution to journalReview article

46 Scopus citations

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 languageEnglish (US)
Pages (from-to)577-579
Number of pages3
JournalSurgical Endoscopy and Other Interventional Techniques
Volume20
Issue number4
DOIs
StatePublished - Apr 1 2006

Keywords

  • Choledocholithiasis
  • Common bile duct exploration
  • Endoscopic retrograde cholangiopancreatography
  • Laparoscopy

ASJC Scopus subject areas

  • Surgery

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