Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients: A technical review |
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Authors: | Bo-Ya Chiu Shu-Hung Chuang Shih-Chang Chuang Kung-Kai Kuo |
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Institution: | Bo-Ya Chiu, School of Post-baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, TaiwanShu-Hung Chuang, Shih-Chang Chuang, Kung-Kai Kuo, Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanShu-Hung Chuang, Shih-Chang Chuang, Kung-Kai Kuo, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan |
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Abstract: | Situs inversus (SI) is a rare congenital condition characterized by a mirror-image transposition of the major visceral organs. Since the 1990s, more than one hundred SI patients have been reported to have successfully undergone laparoscopic cholecystectomy. In these cases, the major problem is to overcome is the left-right condition for right-handed surgeons. Laparoscopic common bile duct exploration (LCBDE), an alternative to treat patients with bile duct stones, has shown equivalent efficacy and is less likely to cause pancreatitis than endoscopic retrograde cholangiopancreatography. Recent updated meta-analyses revealed that a shorter postoperative hospital stay, fewer procedural interventions, cost-effectiveness, a higher stone clearance rate, and fewer perioperative complications are additional advantages of LCBDE. However, the technique is technically demanding, even for skilled laparoscopic surgeons. Conducting LCBDE in patients with difficult situations, such as SI, is more complex than usual. We herein review published SI patients with choledocholithiasis treated by LCBDE, including our own experience, and this paper focuses on the technical aspects. |
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Keywords: | Choledocholithiasis Choledochotomy Laparoscopic common bile duct exploration Single incision Situs inversus Transcystic |
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