BN SO05 - Risk Factors associated with Complications Post-Laparoscopic Common Bile Duct Exploration: A Comprehensive Literature Review

Abstract Background Gallstone-related diseases, particularly common bile duct (CBD) stones, present a significant global health issue. The adoption of laparoscopic common bile duct exploration (LCBDE) has revolutionized the management of these conditions by providing a minimally invasive alternative to open surgery. This literature review aims to identify and analyze the risk factors associated with complications in LCBDE, thereby offering insights to improve patient care and outcomes. Method comprehensive search for primary research studies, systematic reviews, and meta-analyses pertaining to risk factors for complications following LCBDE. The search was conducted on PubMed, focusing on English-language articles published within the last 20 years and encompassing all age groups. Peer-reviewed journal articles were prioritized. All relevant studies reporting complications after LCBDE were eligible for inclusion if available as full texts, structured abstracts, or conference reports. The initial search yielded 826 articles. Exclusion criteria : open surgery, non-English articles, lacking full-text. A total of 29 records were identified by the literature search. Results Laparoscopic common bile duct exploration (LCBDE) is generally safe and effective, with complication rates influenced by patient and procedural factors. Older age, comorbidities, previous abdominal surgeries, high BMI, narrow common bile ducts, and difficult stones increase risks. Experienced surgeons and shorter operative times reduce complications. The transcystic approach and primary suture closure have fewer complications compared to the transductal route and T-tube drainage, respectively. Intraoperative imaging significantly reduces risks by ensuring complete stone clearance and identifying anatomical variations. Tailoring surgical approaches to patient-specific factors and leveraging surgical expertise are crucial for minimizing complications in LCBDE. Conclusion LCBDE emerges as a safe and effective therapeutic modality for addressing conditions impacting the bile ducts (31). The success and utility of LCBDE can be significantly enhanced through the meticulous optimization of patient-related, surgeon-related, and procedure-related factors. By addressing and fine-tuning these key elements, the occurrence of complications associated with LCBDE can be mitigated, thereby reinforcing its potential as a primary choice for managing various bile duct conditions. This strategic approach not only underscores the clinical efficacy of LCBDE but also advocates for its expanded utilization as a frontline intervention in the comprehensive management of bile duct disorders.