%0 Journal Article
%T Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic
%J -
%D 2017
%X 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 ¡À£¿ 12.1 years (range 17 ¨C 71 years). In 22/24 patients (91.7%) ERCP-LC was done successfully. Mean operative time was 105 ¡À 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 ¡À 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 ¡À 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 ¡À 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.
%K Common Bile Duct Stones
%K Common Bile Duct Exploration
%K Endoscopic Retrograde Cholangio-Pancreatography
%K Endoscopic Sphincterotomy
%K Choledocholithiasis
%U http://www.sciencepublishinggroup.com/journal/paperinfo?journalid=253&doi=10.11648/j.js.20170505.11