JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
JKKI, Vol 14, No 2, (2023)

Transcystic versus transcholedochal laparoscopic common bile duct exploration: Choosing the right approach – A Case Series

Singgih Annas Fuadhi (Digestive Division, Department of Surgery, Faculty of Medicine, Gadjah Mada University/RSUP Dr. Sardjito Hospital, Yogyakarta - Sebelas Maret University, Surakarta, Indonesia)
Adeodatus Yuda Handaya (Staff of Digestive Division, Department of Surgery, Faculty of Medicine, Gadjah Mada University/RSUP Dr. Sardjito Hospital, Yogyakarta, Indonesia)
Agus Barmawi (Staff of Digestive Division, Department of Surgery, Faculty of Medicine, Gadjah Mada University/RSUP Dr. Sardjito Hospital, Yogyakarta, Indonesia)
Imam Sofii (Staff of Digestive Division, Department of Surgery, Faculty of Medicine, Gadjah Mada University/RSUP Dr. Sardjito Hospital, Yogyakarta, Indonesia)
Nurcahya Setyawan (Staff of Digestive Division, Department of Surgery, Faculty of Medicine, Gadjah Mada University/RSUP Dr. Sardjito Hospital, Yogyakarta, Indonesia)



Article Info

Publish Date
31 Aug 2023

Abstract

Laparoscopic common bile duct exploration (LCBDE) is a relevant therapeutic option in managing cholecysto-choledocholithiasis. The success of this procedure is highly dependent on selecting an appropriate method, either transcystic or transcoledocal. Intraoperative choledochoscopy proves its importance in evaluating the condition of the choledochal duct and sphincter of Oddi. In this case series, we report 2 cases of patients with complaints of right upper abdominal pain and jaundice. Both patients were diagnosed with multiple cholecysto-choledocholithiasis at Dr. Sardjito Hospital, Yogyakarta. The interventional measures applied to both patients were transcystic and transcoledocal exploration. In the first patient, the transcystic method was chosen because the cystic duct was widening up to 9 mm in diameter. While in the second patient, the transcoledocal method was taken because the diameter of the cystic duct was still within normal limits. The duration of surgery in transcystic surgery was shorter than in transcoledocal surgery, with a time ratio of 129 minutes versus 162 minutes. Postoperatively, both patients were discharged on the second day after the procedure, and both experienced recovery without any significant complications. Overall, LCBDE has been shown to be safe to perform. The one-stage surgical approach has been shown to reduce the risk of complications, cost, and duration of treatment required. The choice between the transcystic or transcoledocal method should be based on each patient’s clinical condition.

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Journal Info

Abbrev

JKKI

Publisher

Subject

Medicine & Pharmacology Public Health

Description

JKKI: Jurnal Kedokteran dan Kesehatan Indonesia is a peer-reviewed journal in the field of medical and health sciences. This journal is designed as a place of dissemination of information and scientific knowledge, which publishes three times a year. It publishes original article, article review, and ...