ABOUT US

SOLVING CHOLEDOCHOLITHIASIS IN A SINGLE ACT

Traditionally patients with bile duct stones and gallbladder in sit have been treated in 2 episodes, First ERCP-ES followed by laparoscopic cholecystectomy, done as a different admission procedure. This approach not only requires 2 admissions but also is more expensive and it is also taxed with the complications associated to ERCP, mainly in young patients.

Recently the managements of this patients in one episode, by laparoscopic cholecystectomy plus bile duct exploration, has been gaining acceptance and moreover is the recommended approach in the NICE guidelines, provided that the appropriate expertise is available.

To make this new approach clearly superior to the traditional ERCP followed by laparoscopic cholecystectomy, we need to tackle the two main problems of the surgical approach: The failure and the bile leak. The latter seems to be minimal when the procedure is performed using the transcystic route.

To achieve those two targets we have adopted what we call the LATEST Approach (Leveraging Access to Technology and Enhanced Surgical Techniques), developed by Dr. Alberto Martínez Isla (Senior Consultant Upper GI Surgery, at London North West Healthcare Trust) this approach  is also used  at the HBP and Pancreas Transplant Unit of the Hospital Universitario de Salamanca.

LATEST involves not only using cutting Edge technology, as ultra-thin scopes and laser and electrohydraulic lithotripsy (LABEL), but also applying technical modifications that we have developed  to improve the outcomes, mainly failure and bile leak, therefore having a direct impact  on the  outcomes.

The objective of the LATEST Course is the learning and adoption of this technique by other teams, we are aiming to achieve this through theoretical sessions lead by international experts, together with live cases with interaction between the operating room and the meeting room. Finally will be complemented with a hands on practice session with the PARA model (Porcine Aorto Renal Artery) and CARA model (Cow Aorto Renal Artery) reproducing the anatomy and the simulation of complicated biliary lithiasis, including lithotripsy (LABEL).

Dr. José E. Quiñones Sampedro

HPB and Pancreas Transplant Unit | Complejo Asistencial Universitario de Salamanca | LATEST Course Scientific Director

Drs. Luis Miguel González Fernández, Carmen Esteban Velasco y Manuel José Iglesias Iglesias

HPB and Pancreas Transplant Unit | Complejo Asistencial Universitario de Salamanca | LATEST Course Collaborators