The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

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Technical Challenges of Laparoscopic Cholecystectomy in Patients with Cholestasis

2015-03

Sorin Păun, Ioan Tănase, Ionuț Negoi, Bogdan Stoica, Mircea Beuran

Although mainly asymptomatic, patients with biliary gallstones frequently associate common bile duct (CBD) stones. A percent ranging between 10-18% (1,2) from the patients that underwent cholecystectomy for gallbladder stones associate CBD lithiasis. The presence of CBD stones can be anticipated in the presence of jaundice, cholangitis, pancreatits, with altered hepatic function, or directly identified by imagistics (3). The percentage of preoperative undiagnosed CBD reaches almost 25% even for the newest imagistics (4). Acute cholecystitis is the most common infectious complication of gallstones, occuring with a frequency of 6-11% for the patients with 7-11 years of symptomatic gallstones (5). Recent studies are showing indirect signs of CBD stones in 37.7% of patients with acute cholecystitis, these signs being noticed for 72 % of patients with prooved choledocholithiasis (6).

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