Nexus Surgical Visitors

Friday 25 May 2012

Publication By Dr Liau Kui Hin and Dr Ho C.K. - Laparoscopic Surgery

Laparoscopic exploration can salvage failed

endoscopic bile duct stone extraction
Vishal G Shelat, MRCSE, MMed, Chung Yip Chan, MD, FRCS, Kui Hin Liau, FRCS, FAMS, Choon Kiat Ho, FRCS, FAMS



Introduction
Conventionally, patients who failed endoscopic removal of common bile duct stones (CBDS) by

endoscopic retrograde cholangiopancreaticography (ERCP) would be treated with open cholecystectomy and common

bile duct exploration. Laparoscopic common bile duct exploration (LCBDE) is an established option for treating CBDS. The

aim of this paper was to look at the feasibility of LCBDE as a salvage procedure after failed endoscopic stone extraction

(ESE). The secondary endpoint was to examine the short-term outcomes of our LCBDE series.

Methods
We retrospectively reviewed a prospective database to study the feasibility of LCBDE as a salvage procedure

for failed ERCP.

Resu lts
Since its inception in 2006, 43 patients had undergone LCBDE at our centre. This was achieved via a

transcystic approach in 25 patients and laparoscopic choledochotomy in 15 patients. There were three conversions. Of

these 43 patients, 21 had a pre-operative attempt at ESE, but only six patients had their ducts cleared endoscopically.

The 15 patients who failed ESE underwent LCBDE, of which 14 achieved successful stone clearance and one required

open conversion. One patient developed a bile leak, which resolved spontaneously. The median length of stay (LOS) for

these 15 patients was three days, while the median LOS for the whole cohort was two days.

Conclusion
LCBDE has been shown to be a safe and effective method for treating CBDS, with the added bonus of a

short hospital stay. Where the expertise is available, LCBDE is a safe option as a salvage procedure for failed ESE.

Keywords: bile duct exploration, cholecystectomy, common bile duct stones, endoscopic stone extraction, laparoscopy

Singapore Med J 2012; 53(5): 313–317

Monday 21 May 2012

Official Opening of Parkway East Medical Centre Clinic

Our Parkway East Medical Centre Clinic Official Opening is on 26 May 2012.
You are invited to join us at the reception at 05-01 Parkway East Medical Centre.

Complimentary Chromogranin A Test at Nexus Surgical Clinic

In the month of June 2012, Nexus Surgical continues to offer free CgA test for patients who are suspected to have carcinoids / neuroendocrine neoplasia (NEN) or on follow-up for NEN. Administrative & handling charges apply. For enquiry, please contact Nurse Li Kar at 65-6235 8633/51 or email us at enquiry@nexussurgical.sg

Nexus Surgical Associates @ Mt Elizabeth Novena Specialist Centre

Come July 2012, Nexus Surgical Associates will have a new clinic at Mt Elizabeth Novena Specialist Centre, 38 Irrawaddy Road, Singapore 329563. The new hospital will have state-of-the-art medical equipments and facilities. For the scope of services, visit us at www.nexussurgical.sg

Continuing Nursing Education @ Mt Elizabeth Medical Centre

Nurses Education Seminar

Date                                    Venue                                Lecture Topic                        

24 May 2012 Thursday
3:30 PM — 4:30 PM
Seminar Room
MOUNT ELIZABETH HOSPITAL
The Philosophy of Pre and Post Operative Care for Major Gastrointestinal Operations 
by Dr Liau Kui Hin
Director & Senior Consultant Surgeon
Nexus Surgical Associates

Nexus Surgical Associates@Parkway East Medical Centre

Nexus Surgical Associates is pleased to announce the new clinic at Parkway East Medical Centre #05-01. The clinic is opened from Monday to Friday 0900 hr - 1700 hr and Saturday 0900 hr to 1300 hr.
For appointment with our surgeons, contact Ms Jainah at 65-6440 4866. Our fax number is 65-6440 9655. Our website is www.nexussurgical.sg.

Our surgeons in Parkway East Medical Centre are:
Dr Liau Kui Hin, Dr Lim Khong Hee, Dr Ho Choon Kait, Dr Lee Chee Wei, Dr Jane Tan