Management of common bile duct stones in a rural area of the United States: results of a survey.
Surg Endosc
; 20(4): 577-9, 2006 Apr.
Article
en En
| MEDLINE
| ID: mdl-16437268
BACKGROUND: Laparoscopic common bile duct exploration has been reported to be highly successful and cost-effective. It remains unknown to what extent the procedure is used in routine surgical practice. METHODS: We conducted a survey of general surgeons practicing in a rural area of the United States. The type of practice, laparoscopic training, performance of cholangiography, and preferred approach to choledocholithiasis were elicited. RESULTS: Sixty-eight of 207 surveys (33%) were returned. Thirty respondents (45%) indicated that they perform laparoscopic common bile duct explorations. The likelihood of laparoscopic common bile duct exploration increased with a higher number of cholecystectomies per year (p < 0.05, chi-square) but was independent of training or routine cholangiography. The preferred approach to a patient with choledocholithiasis was endoscopic retrograde cholangiopancreatography (75%), followed by laparoscopic (21%) and open exploration (4%). Reasons for not performing laparoscopic exploration were time (58%), equipment (24%), good gastrointestinal backup (6%), reimbursement (3%), increased morbidity (1.5%), lack of skill (1.5%), and other/no reason (18%). CONCLUSION: Although 45% of practicing surgeons indicated that they perform laparoscopic common bile duct explorations, only 21% practiced it as their preferred approach. Time constraints and lack of equipment are the main factors preventing the application of the laparoscopic technique toward choledocholithiasis.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Práctica Profesional
/
Población Rural
/
Procedimientos Quirúrgicos del Sistema Biliar
/
Coledocolitiasis
Aspecto:
Determinantes_sociais_saude
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Surg Endosc
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Año:
2006
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Alemania