CONCOMITANT GALLSTONES AND COMMON BILE DUCT STONES: SHOULD SINGLE-STEP LAPAROSCOPIC CHOLECYSTECTOMY IMMEDIATELY AFTER THE ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY?

Abstract

Purpose: To evaluate results from treatment of concomitant gallstones and common bile duct (CBD) stones by ERCP and laparoscopic cholecystectomy. Analysis of single-step or separated-step characteristics. Object: During the 3 years (2015-2017), 285 patients CBD stones concomitant or not gallstones underwent ERCP, 68 patients concomitant gallstones and CBD suitable criteria for inclusion at Hue Central Hospital. Retrospective clinical descriptive study. Results: Average age 52.2±12.5 (24-90), male/female ratio of 0.7/1 (27/41). Abdominal pain was the most common symptom 91.2%, jaundice 51.5%, direct bilirubin increased 27.3±15.6μmol/l (2.2-165). The diameter of CBD stone is 12.4±3.2mm (6-20), gallstones size 11.3±6.2mm (536). The first time CBD stones 95.6%, recurrence CBD stones 4.4%. ERCP and laparoscopic cholecystectomy (LC) 34patients, ERCP 1.4±2.5times and secondary LC. Single-step ductal clearance 76.5%, separatestep ductal clearance 94.1% (p=0.041). Length of hospital stay 6.5±4.3days and 13.6±2.2days (p<0.0001). Conclusions: The percentage of ductal clearance in the separate-step patients group was higher than that single-step patients group with p=0.041. The indication of cholecystectomy immediately endoscopic retrograde cholangio pancreatography should be based on the patient status, the ductal clearance as well as the complications. Key words: Common bile duct stones, Endoscopic retrograde cholangio pancreatography