Evaluation of tri-endoscopy for choledocholithiasis accompanied with cholecystolithiasis

Abstract

Objective To evaluate a method namedone-step i. e., combined duodenoscopy, laparoscopy and choledochoscopy for choledocholithiasis accompanied with cholecystolithiasis. Methods Fifty-three cases with gallbladder stones combined with common bile duct stones diagnosed from February 2012 to February 2014 were assigned to two groups, 29 cases inone-step proceduregroup, who underwent duodenoscopy, laparoscopy and choledochoscopy in one operation, and 24 cases in the control group, who firstly underwent endoscopic sphincterotomy to remove common bile duct stones, and then LC was performed after several days. The rate of complications related to the procedure, success rate of complete stone removal, length of hospital stay and hospitalization expenses were compared between the two groups. Results All 53 patients underwent the surgery and ERCP procedure successfully. There were no significant differences between theone-step proceduregroup and the control group in complication rates[3.4%(1/29)VS 12.5%(3/24), P=0.21], complete stone removal rates[96.6%(28/29)VS 100.0%(24/24), P=0.37]. Differences were significant in length of hospital stay (6.7±1.3d VS 10.9±1.6d, P<0.01) and hospitalization expenses(15 724±1 613 yuan VS 19 829±2 433 yuan, P<0.05)between theone-step proceduregroup and the control group. Conclusion Theone-step the combined duodenoscopy, laparoscopy and choledochoscopy, is safe, effective, and has smaller length of hospital stay and lower hospitalization expenses. Key words: Choledocholith; Choledocholithiasis; Cholangiopancreatography, endoscopic retrograde; Laparoscope