To audit short- and long-term outcomes after laparoscopic common bile duct exploration (LCBDE) and factors influencing the success of the laparoscopic treatment.
From January 1999 to December 2011, 288 patients (93 males) underwent a single-stage laparoscopic cholecystectomy combined with LCBDE in two Finnish Hospitals. Short-term outcome data were collected prospectively. Long-term outcomes were examined retrospectively. The main measures of outcome were the success of laparoscopic CBD stone clearance and recurrence of CBD stones in the long-term, with 30-day mortality, morbidity, and the length of postoperative hospital stay as secondary outcome measures.
CBD stones were successfully removed by one-stage laparoscopic procedure in 232 of the 279 patients (83.2%) with verified CBD stones and after conversion to open surgery in additional 28 patients (93.2%). Nineteen patients (6.8%) having residual stones after surgery were successfully treated with postoperative ERCP. On multivariate analysis, the independent factors associated with a failed laparoscopic stone clearance were stone size over 7 mm [OR 3.51 (95% CI 1.53-8.03), p = 0.003], difficult anatomy [OR 18.01 (5.03-64.49), p