[Laparoscopic Versus Endoscopic Primary Management of Choledocholithiasis. A Retrospective Case-control Study]

Overview

Journal Chirurg

Specialty General Surgery

Date 2012 Apr 6

PMID 22476872

Citations 2

Authors

G Sgourakis

S Lanitis

Ch Karaliotas

I Gockel

M Kaths

C Karaliotas

Affiliations

Soon will be listed here.

Abstract

Background: The aim was to present the long-term results of one-stage laparoscopic procedure for the management of common bile duct (CBD) lithiasis in comparison with the primary endoscopic approach via ERCP.

Patients And Methods: A retrospective case-control study was performed to determine the outcome of patients treated for CBD lithiasis (04/1997 - 11/2011). Data of patients with choledocholithiasis undergoing the two treatment modalities - laparoscopic common bile duct exploration plus laparoscopic cholecystectomy (LCBDE + LC, group A, n = 101) versus endoscopic retrograde cholangiopancreatography/sphincterotomy and laparoscopic cholecystectomy (ERCP/S + LC, group B, n = 116) were matched according to their clinical characteristics. Patients of group A underwent either laparoscopic choledochotomy or transcystic exploration. The policy was to convert to open choledochotomy only after the sequential application of the two treatment modalities (laparoscopic/endoscopic procedure) had failed.

Results: No significant difference in morbidity was found between the groups (group A 8% versus group B 11.2%). Conversion to another procedure was mandatory in 12 out of 101 and 17 out of 116 patients of groups A and B, respectively. The mean follow-up period was 7.8 years (range 1-12 years). Effective laparoscopic treatment of CBD stones (cholecystectomy and CBD clearance) was possible in 89 of the 101 patients in group A (88.1%) compared with 99 of the 116 patients in group B (85.4%) after the endoscopic approach.

Conclusions: This study showes that both - primary endoscopy and one-stage laparoscopic management of CBD lithiasis - are highly effective and safe with comparable results.

Citing Articles

Efficacy analysis of hybrid operating room-based laparoscopic cholecystectomy combined with intraoperative endoscopic retrograde cholangiopancreatography in the treatment of cholelithiasis combined with choledocholithiasis - A case-control study.

Lv S, Wang B, Hu P, Shi B, Zhang W, Wang A J Minim Access Surg. 2023; 19(3):402-407.

PMID: 37282422 PMC: 10449039. DOI: 10.4103/jmas.jmas_180_22.

Synchronous vs sequential laparoscopic cholecystectomy for cholecystocholedocholithiasis.

Ding Y, Deng B, Liu X, Wu J, Xiao W, Wang Y World J Gastroenterol. 2013; 19(13):2080-6.

PMID: 23599628 PMC: 3623986. DOI: 10.3748/wjg.v19.i13.2080.

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