Comparison of clinical efficacy between LCBDE and EST for choledocholithiasis

Abstract

Objective To compare the safety and efficacy of laparoscopic common bile duct exploration (LCBDE) and endoscopic sphincterotomy (EST) in the treatment of common bile duct stones. Methods Clinical data of 80 patients with choledocholithiasis who were diagnosed and treated in Shanxi Dayi Hospital of Shanxi University from January 2015 to December 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to different treatments, all the patients were divided into the LCBDE and EST groups, with 40 cases in each group. In LCBDE group, 22 patients were male and 18 female, aged (48±2) years on average. In EST group, 24 patients were male and 16 female, aged (46±2) years on average. Perioperative conditions were observed in two groups. The operation time and hospitalization expenses between two groups were statistically compared by t test. The surgical success rate and incidence of postoperative complications between two groups were compared by Chi-square test. Results The operation time and hospitalization expenses in LCBDE group were (103.2±2.3) min and (41 310±220) Yuan, significantly higher than (88.8±2.4) min and (34 480±100) Yuan in EST group (t=27.74, 13.61; P 0.05). In LCBDE group, biliary leakage occurred in 2 cases, acute pancreatitis in 1 case and gastrointestinal hemorrhage in 1 case. In EST group, acute pancreatitis occurred in 3 cases, gastrointestinal hemorrhage in 1 case and gastrointestinal perforation in 2 cases. The incidence of postoperative complications was 10%(4/40) in LCBDE group and 15%(6/40) in EST group, where no significant difference was observed (χ2=0.46, P>0.05). No perioperative death occurred in two groups. Conclusions Both LCBDE and EST are safe and efficacious for treating common bile duct stones with slight trauma and mild complications. LCBDE retains the physiological function of Oddi sphincter, which is especially suitable for patients with duodenal stenosis and Oddi sphincter dysfunction, and yields low cost. Key words: Choledocholithiasis; Laparoscopic common bile duct exploration; Sphincterotomy, endoscopic; Cholangiopancreatography, endoscopic retrograde