Cholecystectomy together with endoscopic retrograde cholangiopancreatography in the treatment of cholecystolithiasis complicated with choledocholithiasis

Abstract

Objective To assess the efficacy of cholecystectomy together with endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of cholecystolithiasis complicated with choledocholithiasis. Methods Clinical data of 50 patients with cholecystolithiasis complicated with choledocholithiasis admitted in Sun Yat-sen Memorial Hospital and the Third Affiliated Hospital of Sun Yat-sen University from June 2010 to September 2012, were studied retrospectively. The informed consents of all patients were obtained and the ethics committee approval was received. According to the surgical procedures, the patients were divided into two groups: the cholecystectomy combined with postoperative ERCP group (ERCP group) [26 cases; 12 males and 14 females; (37±4) years old] and cholecystectomy+choledocholithotomy group (choledocholithotomy group) [24 cases; 11 males and 13 females; (40±4) years old]. The operations, total hospital stay, postoperative hospital stay, the incidence of residual bile duct stones and complications were observed. The total hospital stay and postoperative hospital stay were compared by t-test. The incidence of residual bile duct stones and complications were compared by χ2 test. Results The operations in both groups were successfully performed. The total hospital stay of the ERCP group was (16±2) d, which was shorter than that in the choledocholithotomy group (12±2) d(t=8.248, P<0.05). There was 1 case (4%) of patients had residual bile duct stones, while in the choledocholithotomy group, there were 6(25%) patients suffered residual bile duct stones. The incidence of residual bile duct in the ERCP group was statistically significant less than that in the choledocholithotomy group (χ2=3.05, P<0.05). The incidence of postoperative complications was 4%(1/26) in the ERCP group and 25%(6/24) in the choledocholithotomy group respectively. There was significant difference in the 2 groups (χ2=3.05, P<0.05). Conclusions The cholecystectomy together with postoperative ERCP is safe and effective in the treatment of cholecystolithiasis complicated with choledocholithiasis. It can also reduce the incidence of residual bile duct stones. Key words: Cholecystolithiasis; Choledocholithiasis; Cholecystectomy; Cholangiopancreatography, endoscopic retrograde