Bile Duct Exploration and T-tube Drainage Procedure without Endoscopic Retrograde Cholangiopancreatography (ERCP) Unit in Somalia
Creators
- 1. Department of General Surgery, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia.
- 2. Department of Radiology, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia.
Description
Özet
Çalışmamızda, ERCP (endoskopik retrograd kolanjiopankreatografi) yapılamayan koledokolithiyazisli hastalarda açık olarak yapılan T-tüp drenaj prosedürünü değerlendirmek amaçlanmıştır. Hastaların yaş, cinsiyet, laboratuvar değerleri, hastanede yatış süresi, T-tüp çekilme zamanı ve tedaviye yanıtları elektronik kayıtlarından alındı. Preoperatif dönemde tüm hastalar MRCP (magnetik rezonans kolanjio pankreatigografi) ile değerlendirildi. Toplam 16 hastanın 11 (%68.8)’i kadın ve beşi (%31.2)’i erkekti. Hastaların yaş ortalaması 49.7±15 olarak bulundu. Koledok çapı (mm) 15±7.3’dü. Hastaların 8’inde (%50) intrahepatik safra yolları ileri derecede dilate iken, 8’inde (%50) hafif derecede dilatasyon mevcuttu. Biyokimyasal parametrelerinden bilirübin ve kolestaz enzimlerinin düzeyleri yüksek bulundu. Hastaların hastanede yatış süresi ve T-tüp çekilme süresi sırasıyla; 15.3±0.9 ve 13.7±1 olarak bulundu. Seçilmiş hasta grubunda koledokolithiyazis tedavisi için; açık koledok eksplorasyonu, taş ekstraksiyonu ve T-tüp drenajı ERCP’nin olmadığı yerlerde halen uygulanabilirliği olan bir yöntemdir.
Abstract
The aim of this study is to patients with choledocholithiasis who underwent open exploration with T-tube drainage that can’t undergo ERCP (endoscopic retrograde cholangiopancreatography). Materials and methods: Patient age, gender, laboratory workup, period of hospital stay, time of T-tube removal and treatment response were looked back into from the hospital database. All patients underwent MRCP (magnetic resonance Cholangio pancreatography) preoperatively. There were a total of 16 patients of which 11 (68.8%) were female and 5 (31.2%) were males. Mean age was 49.7±15. Common bile duct was 15±7.3 mm in diameter. 8 (50%) of the patients’ intra-hepatic bile ducts were moderately dilated, the rest 8 (50%) patients were minimally dilated. Bilirubin levels and cholestasis enzymes were elevated. Hospital stay period and T-tube removal time were 15.3±0.9 and 13.7±1 respectively. When ERCP is not available, open bile duct exploration, stone extraction and T-tube drainage can be used for choledocholithiasis treatment as feasible method in the selected patient groups.
Notes
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Additional details
References
- 1. Beltran MA, Csendes A, Cruces KS. The relationship of Mirizzi syndrome and cholecystoenteric fistula: validation of a modified classification. World journal of surgery. 2008; 32(10): 2237-43.
- 2. Costi R, Gnocchi A, Di Mario F, Sarli L. Diagnosis and management of choledocholithiasis in the golden age of imaging, endoscopy and laparoscopy. World J Gastroenterol 2014; 20(37): 13382-401.
- 3. Jin PP, Cheng JF, Liu D, Mei M, Xu ZQ, Sun LM. Endoscopic papillary large balloon dilation vs endoscopic sphincterotomy for retrieval of common bile duct stones: a meta-analysis. World J Gastroenterol 2014; 20(18): 5548-56.
- 4. Park CH. The Management of Common Bile Duct Stones. Korean J Gastroenterol 2018; 71(5): 260-3.
- 5. He MY, Zhou XD, Chen H, Zheng P, Zhang FZ, Ren WW. Various approaches of laparoscopic common bile duct exploration plus primary duct closure for choledocholithiasis: A systematic review and meta-analysis. Hepatobiliary Pancreat Dis Int 2018; 17(3): 183-91.
- 6. Naumowicz E, Białecki J, Kołomecki K. Results of treatment of patients with gallstone disease and ductal calculi by single-stage laparoscopic cholecystectomy and bile duct exploration. Wideochir Inne Tech Maloinwazyjne 2014; 9(2): 179-89.
- 7. Zhang JF, Du ZQ, Lu Q, Liu XM, Lv Y, Zhang XF. Risk Factors Associated With Residual Stones in Common Bile Duct Via T Tube Cholangiography After Common Bile Duct Exploration. Medicine (Baltimore) 2015; 94(26): e1043.
- 8. Ozcan N, Kahriman G, Karabiyik O, Donmez H, Emek E. Percutaneous management of residual bile duct stones through T-tube tract after cholecystectomy: A retrospective analysis of 89 patients. Diagn Interv Imaging 2017; 98(2): 149-53.
- 9. Hakuta R, Kawahata S, Kogure H, Nakai Y, Saito K, Saito T, et al. Endoscopic papillary large balloon dilation and endoscopic papillary balloon dilation both without sphincterotomy for removal of large bile duct stones: A propensity-matched analysis. Dig Endosc 2019; 31(1): 59-68.
- 10. Baiu I, Hawn MT. Choledocholithiasis. JAMA 2018; 320(14): 1506.
- 11. Corbett CR, Fyfe NC, Nicholls RJ, Jackson BT. Bile peritonitis after removal of T-tubes from the common bile duct. Br J Surg 1986; 73(8): 641-3.
- 12. Dellinger EP, Steer M, Weinstein M, Kirshenbaum G. Adverse reactions following T-tube removal. World J Surg 1982; 6(5): 610-5.
- 13. Maghsoudi H, Garadaghi A, Jafary GA. Biliary peritonitis requiring reoperation after removal of T-tubes from the common bile duct. Am J Surg 2005; 190(3): 430-3.
- 14. Strömberg C, Nilsson M. Nationwide study of the treatment of common bile duct stones in Sweden between 1965 and 2009. Br J Surg 2011; 98(12): 1766-74.