Transcystic management of choledocholithiasis: Outcomes, factors associated with bile duct injury and implications for surgical practice
Year: 2025
Type: article
Study design: Observational Study
Abstract: Backgrounds/Aims: Choledocholithiasis with gallbladder in situ presents a complex surgical challenge. The transcystic approach offers a minimally invasive alternative to choledochotomy; however, its adoption remains limited. This study assessed the safety, efficacy, and reproducibility of this method. Methods: This retrospective study involved 71 patients diagnosed with choledocholithiasis and gallbladder in situ, all of whom underwent transcystic bile duct exploration at a primary care hospital. Demographic, clinical, and intraoperative variables were analyzed to determine predictors of bile duct injury. Results: = 0.031). Conversion to choledochotomy elevated the risk of injury, and incomplete duct clearance correlated with higher complication rates. No specific intraoperative techniques or devices exhibited a significant impact on outcomes. Imaging at six months demonstrated no persistent strictures, supporting the likelihood of transient inflammatory changes. Conclusions: The transcystic approach is a safe, effective, and reproducible first-line intervention for choledocholithiasis with gallbladder in situ. Patient-specific and disease-related factors primarily determine bile duct injury risk, rather than the surgical technique itself. Further prospective randomized studies are needed to confirm these findings.
Institution: Universidad Francisco de Vitoria
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415648995