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HPB (Oxford) ; 18(12): 959-964, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27838253

RESUMO

BACKGROUND: Common bile duct (CBD) stones can be managed by either endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic common bile duct exploration (LCBDE). The aim of this survey was to document the management of CBD stones by European-African HPB Association (E-AHPBA) members. METHODS: All 331 members of the E-AHPBA were invited by personal email to participate to an online survey. RESULTS: Ninety-three (28%) surgeons replied within 2 months. Responding surgeons were attending surgeons (84%), working as HPB surgeons (75%) in academic hospitals (73%). In patients with clinically suspected CBD stones, MRCP was the preferred diagnostic test for 61% of respondents. LCBDE was the preferred therapeutic strategy for 11 (12%) respondents only. Previous gastric surgery was an absolute contraindication to ERCP for 47% of respondents. Absence of CBD dilation was considered an absolute contraindication for LCBDE in 24% of respondents. Yearly caseload exceeded 10 patients for only 30% of 56 centers performing LCBDE. The transcystic approach was preferred by 39% of surgeons performing LCBDE. There was considerable variation amongst respondents with regard to type and duration of drainage, bile duct closure technique and follow-up after LCBDE. CONCLUSION: Indications for single-stage LCBDE are not standardized and do not appear well established across E-AHPBA members.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica/tendências , Colecistectomia Laparoscópica/tendências , Coledocolitíase/cirurgia , Cálculos Biliares/cirurgia , Padrões de Prática Médica/tendências , Cirurgiões/tendências , Adulto , África , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Colecistectomia Laparoscópica/efeitos adversos , Coledocolitíase/diagnóstico por imagem , Europa (Continente) , Cálculos Biliares/diagnóstico por imagem , Pesquisas sobre Atenção à Saúde , Disparidades em Assistência à Saúde/tendências , Humanos , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Carga de Trabalho
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