Laparoscopic Bile Duct Exploration in Treating Difficult Common Bile Duct Stones in Sawanpracharak Hospital, A tertiary Center in the Lower Northern Region of Thailand

Objective: To study the effectiveness of laparoscopic bile duct exploration in treating patients with difficult common bile duct stones (CBD stones) in Sawanpracharak Hospital, a single tertiary hospital. Methods: Retrospective data collection of patients with difficult common bile duct stones treated with laparoscopic bile duct exploration (LBDE) from September 2015 to December 2016. Results: Thirteen patients were included in the study (nine males, six females) ranging from 26 to 92 years of age (Mean: 67.3 ± 23.3). Operative time and hospital stay averaged 169 minutes (95% CI: 144.3 - 194.9) and 7.6 days (95% CI: 4.8 - 10.4) respectively. All bile duct stones were successfully cleared. There were no mortalities and one patient (8.3 %, 95% CI: 2.1 - 38.5) suffered from a superficial surgical site infection. Conversion to open surgery was required in three cases (20.0 %, 95% CI: 4.3 - 48.1), due to Mirizzi’s syndrome. Conclusion: In patients with difficult common bile duct stones, laparoscopic bile duct exploration appears to be a safe and effective form of treatment. However, due to the variety of difficult common bile duct stones cases, the open surgery conversion rate and duration of treatment times were both relatively high