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Showing content from https://link.springer.com/doi/10.1007/s00464-005-0322-3 below:

Management of common bile duct stones in a rural area of the United States

Laparoscopic common bile duct exploration has been reported to be highly successful and cost-effective. It remains unknown to what extent the procedure is used in routine surgical practice.

We conducted a survey of general surgeons practicing in a rural area of the United States. The type of practice, laparoscopic training, performance of cholangiography, and preferred approach to choledocholithiasis were elicited.

Sixty-eight of 207 surveys (33%) were returned. Thirty respondents (45%) indicated that they perform laparoscopic common bile duct explorations. The likelihood of laparoscopic common bile duct exploration increased with a higher number of cholecystectomies per year (p < 0.05, chi-square) but was independent of training or routine cholangiography. The preferred approach to a patient with choledocholithiasis was endoscopic retrograde cholangiopancreatography (75%), followed by laparoscopic (21%) and open exploration (4%). Reasons for not performing laparoscopic exploration were time (58%), equipment (24%), good gastrointestinal backup (6%), reimbursement (3%), increased morbidity (1.5%), lack of skill (1.5%), and other/no reason (18%).

Although 45% of practicing surgeons indicated that they perform laparoscopic common bile duct explorations, only 21% practiced it as their preferred approach. Time constraints and lack of equipment are the main factors preventing the application of the laparoscopic technique toward choledocholithiasis.

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1. Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA

   J. Bingener & W. H. Schwesinger

1. J. Bingener
2. W. H. Schwesinger

Correspondence to J. Bingener.

Bingener, J., Schwesinger, W.H. Management of common bile duct stones in a rural area of the United States. Surg Endosc 20, 577–579 (2006). https://doi.org/10.1007/s00464-005-0322-3

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• Received: 27 April 2005

• Accepted: 29 July 2005

• Published: 25 January 2006

• Issue Date: April 2006

• DOI: https://doi.org/10.1007/s00464-005-0322-3

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