Abstract
Background: This study details Assiut and South Valley universities experience in treating combined gall bladder and common bile duct stones in a single session, either with Endoscopic Retrograde Cholangio-Pancreatography (ERCP) for Common Bile Duct (CBD) stone extraction followed by laparoscopic cholecystectomy (LC), or totally laparoscopic treatment. Patients and methods: In this prospective randomized study, 46 consecutive patients with confirmed cholecysto-choledocholithiasis were randomized to 2 groups. Group (A) included 24 patients treated with single-session ERCP for CBD stone extraction and laparoscopic cholecystectomy [ERCP-LC]. Group (B) included 22 patients treated with laparoscopic CBD exploration and laparoscopic cholecystectomy [LCBDE-LC]. Demographic data, operative time, CBD clearance success rate, short term complications and duration of hospital stay were recorded. Results: Patients included 28 females and 18 males with mean age of 42.1 ± 12.1 years (range 17 – 71 years). In 22/24 patients (91.7%) ERCP-LC was done successfully. Mean operative time was 105 ± 19.1 minutes (50-150 min.). No intra-operative complications occurred. Early post-operative complications occurred in 3 patients (12.5%). Mean hospital stay was 2.1 ± 0. 91 days (1-6 days). In the other group, LCBDE-LC was performed successfully in 22/22 patients (100%). Mean operative time was 145 ± 23 minutes (100-180 min.). Minor intra-operative complications (bleeding) occurred in 2/22 cases (9%). Minor early post-operative complications (bile leak, ileus, bleeding) occurred in 4/22 patients (18%). Mean hospital stay was 2.8 ± 0.83 days (2-7 days). Conclusion: Single session ERCP-LC and LCBDE-LC procedures for management of cholecysto-choledocholithiasis are feasible, safe, and effective and have comparable outcome regarding success rate, peri-operative complications. ERCP-LC has statistically significant less operative time and less hospital stay.
Highlights
20% of symptomatic gall bladder stones are associated with common bile duct stones
The aim of this study is to compare the outcome of intraoperative Endoscopic Retrograde Cholangio-Pancreatography (ERCP) followed by laparoscopic cholecystectomy (ERCP-LC) versus totally laparoscopic common bile duct exploration and laparoscopic cholecystectomy (LCBDE-LC) as a single session for treatment of cholecystocholedocholithiasis regarding success rate, operative time and perioperative complications
Patients were suitable for either interventions, ERCP-LC or laparoscopic CBD exploration and stone extraction (LCBDE)-LC
Summary
20% of symptomatic gall bladder stones are associated with common bile duct stones. Mostafa Mohamoud Sayed et al.: Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic for CBD stones extraction is a relatively safe and effective option for removing CBD stones in most cases avoiding CBD exploration [5]. Albeit, it necessitates a second procedure and there is a risk that it will be unsuccessful, requiring surgical CBD exploration [6]. This study details Assiut and South Valley universities experience in treating combined gall bladder and common bile duct stones in a single session, either with Endoscopic Retrograde Cholangio-Pancreatography (ERCP) for Common Bile Duct (CBD) stone extraction followed by laparoscopic cholecystectomy (LC), or totally laparoscopic treatment. ERCP-LC has statistically significant less operative time and less hospital stay
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
