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Cholezystolithiasis/Choledocholithiasis

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Book cover Evidenzbasierte Viszeralchirurgie benigner Erkrankungen

Part of the book series: Evidenzbasierte Chirurgie ((EC))

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Zusammenfassung

10–15 % der erwachsenen Bevölkerung sind Gallensteinträger. Obwohl deutlich weniger als die Hälfte der Patienten Symptome entwickeln, gehört die symptomatische Cholezystolithiasis zu den häufigsten viszeralmedizinischen Erkrankungen in Deutschland. Bei unkomplizierter Cholezystolithiasis mit entsprechenden typischen Beschwerden, aber auch bei der akuten Cholezystitis besteht die Indikation zur laparoskopischen Cholezystektomie. Zur Vermeidung von Komplikationen ist ein streng standardisiertes Vorgehen empfohlen. Bei Auftreten einer Choledocholithiasis steht die endoskopische Steinextraktion an erster Stelle. Die Risikoabschätzung für das Vorhandensein einer Choledocholithiasis ist von großer Bedeutung, um unnötige endoskopische Sphinkterotomien zu vermeiden. Die obstruktive steinbedingte akute Cholangitis und Pankreatitis sollten umgehend durch eine endoskopische Beseitigung des Steins behandelt werden.

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Literatur

  • Agresta F, Ansaloni L, Baiocchi GL, Bergamini C, Campanile FC, Carlucci M et al (2012) Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Societá Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società die Chirurgia d´Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell´Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES). Surg Endosc 26(8):2134–2164

    Article  PubMed  Google Scholar 

  • Ahmed M, Diggory R (2011) The correlation between ultrasonography and histology in the search for gallstones. Ann R Coll Surg Engl 93:81–83

    Article  CAS  PubMed  Google Scholar 

  • Akyurek N, Salman B, Yuksel O, Tezcaner T, Irkorucu O, Yucel C, Oktar S, Tatlicioglu E (2005) Management of acute calculous cholecystitis in high-risk patients: percutaneous cholecystotomy followed by early laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 15(6):315–320

    Article  PubMed  Google Scholar 

  • Ansaloni L, Pisano M, Coccolini F et al (2016) WSES guidelines on acute calculous cholecystitis. World Journal of Emergency Surgery 11:52

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Attili AF, De Santis A, Capri R et al (1995) The natural history of gallstones: the GREPCO experience. Hepatology 21:655–660

    Article  CAS  PubMed  Google Scholar 

  • Azuma T, Yoshikawa T, Araida T, Takasaki K (2001) Differential diagnosis of polypoid lesions of the gallbladder by endoscopic ultrasonography. Am J Surg 181(1):65–70

    Article  CAS  PubMed  Google Scholar 

  • van Baal MC, Besselink MG, Bakker OJ, van Santvoort HC, Schaapherder AF, Nieuwenhuijs VB, Gooszen HG, van Ramshorst B, Boerma D (2012) Timing of cholecystectomy after mild biliary pancreatitis: a systematic review. Ann Surg 255(5):860–6

    Article  PubMed  Google Scholar 

  • Banz V, Gsponer T, Candinas D, Guller U (2011) Population-based analysis of 4113 patients with acute cholecystitis: defining the optimal time-point for laparoscopic cholecystectomy. Ann Surg 254(6):964–970

    Article  PubMed  Google Scholar 

  • Bergman JJ, van den Brink GR, Rauws EA, de Wit L, Obertop H, Huibregetse K et al (1996) Treatment of bile duct lesions after laparoscopic cholecystectomy. Gut 38:141–147

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Borchert D H, Federlein M, Fritze-Buttner F, Burghardt J, Liersch-Lohn B, Atas Y, Muller V, Ruckbeil O, Wagenpfeil S, Graber S, Gellert K (2014) Postoperative pain after transvaginal cholecystectomy: single-center, double-blind, randomized controlled trial. Surg Endosc 28(6):1886–1894

    Article  PubMed  Google Scholar 

  • Boys JA, Doorly MG, Zehetner J, Dhanireddy KK, Senagore AJ (2014) Can ultrasound common bile duct diameter predict dommon bile duct stones in the setting of acute cholecystitis? Am J Surg 207:432–435

    Article  PubMed  Google Scholar 

  • Buddingh K T, Nieuwenhuijs V B, van Buuren L, Hulscher J B, de Jong J S, van Dam G M (2011) Intraoperative assessment of biliary anatomy for prevention of bile duct injury: a review of current and future patient safety interventions Surg Endosc 25(8):2449–2461

    Article  PubMed  PubMed Central  Google Scholar 

  • Bundesgeschäftsstelle Qualitätssicherung (2006) BQS-Bundesauswertung 2005 Cholezystektomie. Düsseldorf, 1–26

    Google Scholar 

  • Cariati A, Piromalli E, Cetta F (2014) Gallbladder cancers: associated conditions, histological types, prognosis, and prevention. Eur J Gastroenterol Hepatol 26(5):562–569

    Article  PubMed  Google Scholar 

  • Curret MJ (2006) Laparoscopy during pregnancy. In: Scott-Conner CE (Hrsg), The SAGES manual. Fundamentals of laparoscopy, thoracoscopy and GI-endoscopy. Springer, New York 84–89

    Google Scholar 

  • da Costa DW, Schepers NJ, Römkens TE, Boerma D, Bruno MJ, Bakker OJ (2016) Endoscopic sphincterotomy and cholecystectomy in acute biliary pancreatitis. Surgeon 14(2):99–108

    Article  PubMed  Google Scholar 

  • Dasari BV, Tan CJ, Gurusamy KS, Martin DJ, Kirk G, McKie L et al (2013) Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev 12:CD003327

    Google Scholar 

  • Date RS, Kaushal M, Ramesh A (2008) A review of the management of gallstone disease and its complications in pregnancy. Am J Surg 196(4):599–608

    Article  CAS  PubMed  Google Scholar 

  • EASL (2016) Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones, J Hepatol 65(1):146–181

    Article  Google Scholar 

  • Eikermann M, Siegel R, Broeders I, Dziri C, Fingerhut A, Gutt C, Jaschinski T, Nassar A, Paganini A M, Pieper D, Targarona E, Schrewe M, Shamiyeh A, Strik M, Neugebauer E A (2012) Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc 26(11):3003–3039

    Article  CAS  PubMed  Google Scholar 

  • Ellner SJ, Myers TT, Piorkowski JR, Mavanur AA, Barba CA (2007) Routine cholecystectomy is not mandatory during morbid obesity surgery. Surg Obes Relat Dis 3:456–460

    Article  PubMed  Google Scholar 

  • van Erpecum KJ (2006) Gallstone disease. Complications of bile-duct stones: Acute cholangitis and pancreatitis. Best Pract Res Clin Gastroenterol 20(6):1139–1152

    Article  PubMed  Google Scholar 

  • Festi D, Reggiani ML, Attili AF, Loria P, Pazzi P, Scaioli E, Capodicasa S, Romano F, Roda E, Colecchia A (2010) Natural history of gallstone disease: Expectant management or active treatment? Results from a population-based cohort study. J Gastroenterol Hepatol 25:719–724

    Article  PubMed  Google Scholar 

  • Friedman G D, Raviola C A, Fireman B (1989) Prognosis of gallstones with mild or no symptoms: 25 years of follow-up in a health maintenance organization. J Clin Epidemiol 42(2):127–136

    Article  CAS  PubMed  Google Scholar 

  • Goetze T O, Paolucci V (2014) [Incidental T1b-T3 gallbladder carcinoma Extended cholecystectomy as an underestimated prognostic factor-results of the German registry]. Chirurg 85(2):131–138

    Article  CAS  PubMed  Google Scholar 

  • Guidelines Committee of the Society of American Gastrointestinal and Endoscopic Surgeons, Yumi H (2008) Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy: this statement was reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), September 2007. It was prepared by the SAGES Guidelines Committee. Surg Endos 22(4): 849–861

    Google Scholar 

  • Gurusamy KS, Giljaca V, Takwoingi Y, Higgie D, Poropat G, Stimac D, Davidson BR (2015) Ultrasound versus liver funktion tests for diagnosis of common bile duct stones. Cochrane Database Syst Rev 2:CD011548

    Google Scholar 

  • Gurusamy KS, Samraj K (2006) Early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Cochrane Database Syst Rev (4):CD005440

    Google Scholar 

  • Gurusamy KS, Vaughan J, Ramamoorthy R, Fusai G, Davidson BR (2013) Miniports versus standard ports for laparoscopic cholecystectomy. Cochrane Database Syst Rev Aug 1;(8):CD006804

    Google Scholar 

  • Gurusamy KS, Vaughan J, Rossi M, Davidson BR (2014) Fewer-than-four ports versus four ports for laparoscopic cholecystectomy. Cochrane Database Syst Rev Feb 20;(2):CD007109

    Google Scholar 

  • Gutt CN, Encke J, Köninger J, Harnoss JC, Weigand K, Kipfmüller K, Schunter O, Götze T, Golling MT, Menges M, Klar E, Feilhauer K, Zoller WG, Ridwelski K, Ackmann S, Baron A, Schön MR, Seitz HK, Daniel D, Stremmel W, Büchler MW (2013) Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304). Ann Surg 258(3):385–393

    Article  PubMed  Google Scholar 

  • Hatzidakis A A, Prassopoulos P, Petinarakis I, Sanidas E, Chrysos E, Chalkiadakis G, Tsiftsis D, Gourtsoyiannis NC (2002) Acute cholecystitis in high-risk patients: percutaneous cholecystostomy vs conservative treatment. Eur Radiol 12(7):1778–1784

    Article  PubMed  Google Scholar 

  • Heyder N, Gunter E, Giedl J, Obenauf A, Hahn EG (1990) Polypoide Läsionen der Gallenblase. Dtsch Med Wochenschr 115:243–247

    Article  CAS  PubMed  Google Scholar 

  • Ji W, Li LT, Wang ZM, Quan ZF, Chen XR, Li JS (2005) A randomized controlled trial of laparoscopic versus open cholecystectomy in patients with cirrhotic portal hypertension. World J Gastroenterol 11:2513–2517

    Article  PubMed  PubMed Central  Google Scholar 

  • Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L (2003) Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial. J Gastrointest Surg 7(5):642–645

    Article  PubMed  Google Scholar 

  • Kao LS, Flowers C, Flum DR (2005) Prophylactic cholecystectomy in transplant patients: a decision analysis J Gastrointest Surg 9:965–972

    Article  PubMed  Google Scholar 

  • Ko C W (2006) Risk factors for gallstone-related hospitalization during pregnancy and the postpartum. Am J Gastroenterol 101(10):2263–2268

    Article  PubMed  Google Scholar 

  • Kwon AH, Inui H, Matsui Y, Uchida Y, Hukui J, Kamiyama Y (2004) Laparoscopic cholecystectomy in patients with porcelain gallbladder based on the preoperative ultrasound findings. Hepatogastroenterology 51:950–953

    PubMed  Google Scholar 

  • Lai EC, Mok FP, Tan ES, Lo CM, Fan ST, You KT, Wong J (1992) Endoscopic biliary drainage for severe acute cholangitis. N Engl J Med Jun 11;326(24):1582–1586

    Article  CAS  PubMed  Google Scholar 

  • Lammert et al (2016) EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol 65(1):146–181

    Article  Google Scholar 

  • Lee KF, Wong J, Li JC, Lai PB (2004) Polypoid lesions of the gallbladder. Am J Surg 188(2),186–190

    Article  PubMed  Google Scholar 

  • Lirici MM, Tierno SM, Ponzano C (2016) Single-incision laparoscopic cholecystectomy: does it work? A systematic review. Surg Endosc 30(10): 4389-4399

    Google Scholar 

  • Loozen CS, Blessing M, van Ramshorst B, van Santvoort HC, Boerma D (2017) The optimal treatment of patients with mild and moderate acute cholecystitis: time for a revision of the Tokyo Guidelines. Surg Endosc 2017 Jan 26. doi: https://doi.org/10.1007/s00464-016-5412-x. [Epub ahead of print]

    Google Scholar 

  • Luna, R A, Nogueira, D B, Varela, P S, Rodrigues Neto, Ede O, Norton, M J, Ribeiro, Ldo C, Peixoto, A M, de Mendonca, Y L, Bendet, I, Fiorelli, R A, Dolan, J P (2013) A prospective, randomized comparison of pain, inflammatory response, and short-term outcomes between single port and laparoscopic cholecystectomy. Surg Endosc 27(4):1254–1259

    Article  PubMed  Google Scholar 

  • Machi J, Tateishi T, Oishi AJ et al (1999) Laparoscopic ultrasonography versus operative chlangiography during laparoscopic cholecystectomy: review of the literature and a comparison with open intraoperative ultrasonography. J Am Coll Surg 188:361–7

    Google Scholar 

  • Maple J T, Ben-Menachem T, Anderson M A, Appalaneni V, Banerjee S, Cash B D, Fisher L, Harrison M E, Fanelli R D, Fukami N, Ikenberry S O, Jain R, Khan K, Krinsky M L, Strohmeyer L, Dominitz JA, ASGE Standards of Practice Committee (2010) The role of endoscopy in the evaluation of suspected choledocholithiasis. Gastrointest Endosc 71(1):1–9

    Article  PubMed  Google Scholar 

  • Matos AS, Baptista HN, Pinheiro C, Martinho F (2010) Gallbladder polyps: how should they be treated and when? Rev Assoc Med Bras 56(3):318–21

    Article  PubMed  Google Scholar 

  • Milas M, Deveđija S, Trkulja V (2014) Single incision versus standard multiport laparoscopic cholecystectomy: up-dated systematic review and meta-analysis of randomized trials. Surgeon 12(5):271–289

    Article  PubMed  Google Scholar 

  • Nathanson LK, O'Rourke NA, Martin IJ, Fielding GA, Cowen AE, Roberts RK, Kendall BJ, Kerlin P, Devereux BM (2005) Postoperative ERCP versus laparoscopic choledochotomy for clearance of selected bile duct calculi: a randomized trial. Ann Surg 242(2):188–192

    Article  PubMed  PubMed Central  Google Scholar 

  • National Institute for Health and Care Excellence (2015) Gallstone disease-Diagnosis and management of cholelithiasis, cholecystitis and choledocholithiasis. Clinical Guideline 188. Methods, evidence and recommendations October 2014

    Google Scholar 

  • Okamoto M, Okamoto H, Kitahara F, Kobayashi K, Karikome K, Miura K, Matsumoto Y, Fujino M A (1999) Ultrasonographic evidence of association of polyps and stones with gallbladder cancer. Am J Gastroenterol 94(2):446–450

    Article  CAS  PubMed  Google Scholar 

  • Onken JE, Brazer SR, Eisen GM, Williams DM, Bouras EP, DeLong ER et al (1996) Predicting the presence of choledocholithiasis in patients with symptomatic choledocholithiasis. Am J Gastroenterol 91:762–767

    CAS  PubMed  Google Scholar 

  • Overby DW, Apelgren KN, Richardson W, Fanelli R, Society of American Gastrointestinal and Endoscopic Surgeons (2010) SAGES guidelines for the clinical application of laparoscopic biliar tract surgery. Surg Endosc 24(10):2368–2386

    Article  PubMed  Google Scholar 

  • Patel KR, White SC, Tejirian T, Han SH, Russell D, Vira D et al (2006) Gallbladder management during laparoscopic Roux-en-Y gastric bypass surgery: routine preoperative screening for gallstones and postoperative prophylactic medical treatment are not necessary. Am Surg 72:857–861

    PubMed  Google Scholar 

  • Rickes S, Treiber G, Mönkemöller K et al (2006) Impact of the operateur´s experience on value of high-resolution transabdominal ultrasound on the diagnosis of choledocholithiasis: a prospective comparison using endoscopic retrograd cholangiograpy as the gold standard. Scand J Gastroenterol 41:838–843

    Article  PubMed  Google Scholar 

  • Sanabria A, Dominguez LC, Valdivieso E, Gomez G (2010) Antibiotic prophylaxis for patients undergoing elective laparoscopic cholecystectomy. Cochrane Database Syst Rev (12):CD005265

    Google Scholar 

  • Sauerland S, Agresta F, Bergamaschi R, Borzellino G, Budzynski A, Champault G, Fingerhut A, Isla A, Johansson M, Lundorff P, Navez B, Saad S, Neugebauer EAM (2006) Laparoscopy for abdominal emergencies – Evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc 20:14–29

    Article  CAS  PubMed  Google Scholar 

  • S3-Leitlinie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten und der Deutschen Gesellschaft für Viszeralchirurgie zur Diagnostik und Behandlung von Gallensteinen. AWMF-Register-Nr. 021/008. Überarbeitete Fassung: Stand Juni 2017

    Google Scholar 

  • Stephen AE, Berger DL (2001) Carcinoma in the porcelain gallbladder: a relationship revisited. Surgery 129:699–703

    Article  CAS  PubMed  Google Scholar 

  • Takada T, Strasberg SM, Solomkin JS et al.; Tokyo Guidelines Revision Committee (2013)TG13: Updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 20(1):1–7

    Google Scholar 

  • Thistle JL, Cleary PA, Lachin JM, Tyor MP, Hersh T (1984) The natural history of cholelithiasis: the National Cooperative Gallstone Study. Ann Intern Med 101:171–175

    Article  CAS  PubMed  Google Scholar 

  • Thorboll J, Vilmann P, Jacobsen B, Hassan H (2004) Endoscopic ultrasonography in detection of cholelithiasis in patients with biliary pain and negative transabdominal ultrasonography. Scand J Gastroenterol 39:267–269

    Article  CAS  PubMed  Google Scholar 

  • Tse F, Yuan Y (2012) Early routine endoscopic retrograde cholangiopancreatography strategy versus early conservative management strategy in acute gallstone pancreatitis. Cochrane Database Syst Rev 2012 May 16;(5):CD009779

    Google Scholar 

  • Tsirline V B, Keilani Z M, El Djouzi S, Phillips R C, Kuwada T S, Gersin K, Simms C, Stefanidis D (2014) How frequently and when do patients undergo cholecystectomy after bariatric surgery? Surg Obes Relat Dis 10(2):313–321

    Article  PubMed  Google Scholar 

  • Verma D, Kapadia A, Eisen GM, Adler DG (2006) EUS vs MRCP for detection of choledocholithiasis. Gastrointest Endosc 64(2):248–254

    Article  PubMed  Google Scholar 

  • Warschkow R, Tarantino I, Ukegjini K, Beutner U, Guller U, Schmied B M, Muller S A, Schultes B, Thurnheer M (2013) Concomitant cholecystectomy during laparoscopic Roux-en-Y gastric bypass in obese patients is not justified: a meta-analysis. Obes Surg 23(3), 397–407

    Google Scholar 

  • Williams E, Beckingham I, El Sayed G, Gurusamy K, Sturgess R, Webster G, Young T (2017)Updated guideline on the management of common bile duct stones (CBDS). Gut 66(5):765–782

    Google Scholar 

  • Working Group IAP/APA (2013) Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology Jul-Aug;13(4 Suppl 2)

    Google Scholar 

  • Worni M, Guller U, Shah A, Gandhi M, Shah J, Rajgor D, Pietrobon R, Jacobs D O, Ostbye T (2012) Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008. Obes Surg 22(2):220–229

    Article  PubMed  Google Scholar 

  • Yan R C, Shen S Q, Chen Z B, Lin F S, Riley J (2011) The role of prophylactic antibiotics in laparoscopic cholecystectomy in preventing postoperative infection: a meta-analysis. J Laparoendosc Adv Surg Tech A 21(4):301–306

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinikum Memmingen, Allgemein-Visceral-Gefäß- und Thoraxchirurgie, Bismarckstraße 23, 87700, Memmingen, Deutschland

    C Gutt

  2. Klinikum Memmingen, Allgemein-Visceral-Gefäß- und Thoraxchirurgie, Bismarckstraße 23, 87700, Memmingen, Deutschland

    H Listle

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  1. C Gutt
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  1. Allgemein-,Viszeral-, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany

    Christoph-Thomas Germer

  2. Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany

    Tobias Keck

  3. ehem. Wissenschaftlich Medizinischer, Direktor Kreiskliniken Altötting-Burghausen, Burghausen, Germany

    Reinhart T. Grundmann

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Gutt, C., Listle, H. (2017). Cholezystolithiasis/Choledocholithiasis. In: Germer, CT., Keck, T., Grundmann, R. (eds) Evidenzbasierte Viszeralchirurgie benigner Erkrankungen. Evidenzbasierte Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53553-0_13

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