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Laparoscopic choledochotomy followed by primary duct closure for choledocholithiasis

机译：腹腔镜胆总管切开术，然后行主导管闭合治疗胆总管结石

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摘要

We read with interest the article by Khaled et al. [1]. We appreciate that they shared their experience in the setting of choledocholithiasis via laparoscopic choledochotomy followed by primary duct closure, however we have several concerns regarding their study. The average diameter of common bile duct in their series was 9.4 mm (range 3-30 mm). We have also carried out more than 50 cases of laparoscopic bile duct exploration in our institution. In our practice, it is technically challenging to perform laparoscopic choledochotomy and choledochoscopy (5 mm in diameter) for patients without dilated common bile duct. Furthermore, single-stage management is not suitable for poor-risk patients, including those with cholangitis, deep jaundice, coagulopathy, and severe pancreatitis [2]. The selection criteria for laparoscopic choledochotomy followed by primary duct closure for choledocholithiasis may be better defined.
机译：我们感兴趣地阅读了Khaled等人的文章。 [1]。我们赞赏他们分享了通过腹腔镜胆总管切开术并随后进行原发性导管闭合术治疗胆总管结石的经验，但是我们对他们的研究存在一些担忧。他们的系列中胆总管的平均直径为9.4 mm（范围3-30 mm）。我们还开展了50多例腹腔镜胆管探查术。在我们的实践中，对没有扩张胆总管的患者进行腹腔镜胆总管切开术和胆道镜检查（直径5 mm）在技术上具有挑战性。此外，单阶段治疗不适用于高危患者，包括胆管炎，深黄疸，凝血病和严重胰腺炎[2]。腹腔镜胆总管切开术后胆总管结石的原发性导管闭合的选择标准可能会更好地确定。

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