Cholelithiasis – Related resources

Cochrane reviews

• Open bile duct surgery is superior to ERCP and laparoscopic stone clearance is as effective as ERCP in achieving common bile duct stone clearance. ERCP results in increased number of total procedures.
• The mortality range of laparoscopic cholecystecomy appears to be 9 - 16 per 10,000, common bile duct injury range 35 - 45 per 10,000 and conversion rate to open cholecystectomy around 5%.
• Drains increase the harms to the patient without providing any additional benefit for patients undergoing open or laparoscopic cholecystectomy and should be avoided .
• Prophylactic cholecystectomy decreases the risk of death or of complications from gallstones in patients whose choledocholithiasis has been cleared by endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy .
• Abdominal wall lift may not have a clear benefit over pneumoperitoneum in patients with mild or no systemic disease undergoing laparoscopic cholecystectomy. It may decrease cardiopulmonary changes, but does not influence the morbidity and, increases operating time .
• Early laparoscopic cholecystectomy (< 24 hours of diagnosis of biliary colic) seems to decrease the morbidity during the waiting period for elective laparoscopic cholecystectomy, the rate of conversion to open cholecystectomy, operating time and hospital stay, but the evidence is insufficient .
• Cholecystectomy in gallbladder dyskinesia seems to improve pain symptoms, but there are insufficient data from adequately performed trials .
• Robot-assisted laparoscopic cholecystectomy seems to be safe but may not offer any advantage over human-assisted laparoscopic cholecystectomy, although the evidence is insufficient .

Other Internet resources

• Carcinoma of the gallbladder. Orphanet ORPHA56044

Literature

Martin DJ, Vernon DR, Toouli J. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev 2006 Apr 19;(2):CD003327.
• Williams EJ, Green J, Beckingham I, Parks R, Martin D, Lombard M, British Society of Gastroenterology. Guidelines on the management of common bile duct stones (CBDS). Gut 2008 Jul;57(7):1004-21.
• Strasberg SM. Clinical practice. Acute calculous cholecystitis. N Engl J Med 2008 Jun 26;358(26):2804-11.
• Neoptolemos JP, Carr-Locke DL, London NJ, Bailey IA, James D, Fossard DP. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones. Lancet 1988 Oct 29;2(8618):979-83.
• Fan ST, Lai EC, Mok FP, Lo CM, Zheng SS, Wong J. Early treatment of acute biliary pancreatitis by endoscopic papillotomy. N Engl J Med 1993 Jan 28;328(4):228-32.
• Fölsch UR, Nitsche R, Lüdtke R, Hilgers RA, Creutzfeldt W. Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis. N Engl J Med 1997 Jan 23;336(4):237-42.
• Karjalainen J, Airo I, Nordback I. Routine early endoscopic cholangiography, sphincterotomy and removal of common duct stones in acute gallstone pancreatitis. Eur J Surg 1992 Oct;158(10):549-53.
• Liu CL, Lo CM, Fan ST. Acute biliary pancreatitis: diagnosis and management. World J Surg 1997 Feb;21(2):149-54. Martin DJ, Vernon DR, Toouli J. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev 2006 Apr 19;(2):CD003327.