EXPLORE: 3-YEAR CASE SERIES OF LCBDE vania1999moreira@gmail.com

 

EXPLORE: 3-YEAR CASE SERIES OF LCBDE

4

Portugal

Oral or Poster

Choledocholithiasis is detected in 10-15% of patients undergoing cholecystectomy for symptomatic cholelithiasis. While the optimal treatment strategy is under debate, laparoscopic common bile duct exploration (LCBDE) allows cholecystectomy and removal of bile duct stones at a single-stage. We present a 3-year case series with the aim of characterizing treated population, identifying trends in surgical management at our institution and report on results.

Retrospective analysis on patients undergoing LCBDE from May/2022-May/2025. Collected data: epidemiology, diagnosis, laboratory, imaging findings, LCBDE-context and techniques, intraoperative-cholangiography (IOC) findings and follow-up data. Statistical analysis was performed with IBM SPSS Statistics (version 29.0).

Total of 80 patients. 61% were females, median age:71.5years, median Charlson Comorbidity Index:4. 15% of LCBDE were emergencies, 55% semi-elective and 30% elective. Cholangitis was the most frequent diagnosis. CT scan was the preferred imagiological method, in 81%. Average number of stones was 1.82, average stone-size was 8.32mm, average bile-duct-diameter was 11.46mm. Transcholedochic via was used in 62,5%. Impaction was at lower-CBD in 72.1%, lower and proximal-CBD in 24%. Median number of extracted stones was 2. Basket-retrieval was the preferred method of stone extraction. Ductal clearance was achieved in 88.75%. Median post-operative length-of-stay was 5 days. Thirty-day complications with Clavien-Dindo grade-3a or greater were found on 6% of patients. Mortality: 0%.

In a comorbid, elder cohort, single‑stage LCBDE with cholecystectomy cleared ductal stones in almost 90 % of cases, with zero mortality and a low major‑complication rate. These results demonstrate that modern LCBDE is no longer a niche option but a robust first‑line solution.