Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic
Journal of Surgery
Volume 5, Issue 5, October 2017, Pages: 72-78
Received: Jul. 2, 2017;
Accepted: Jul. 11, 2017;
Published: Sep. 13, 2017
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Mostafa Mohamoud Sayed, General Surgery Department, Faculty of Medicine, Assuit University, Assiut, Egypt
Ayman Kamal, General Surgery Department, Faculty of Medicine, Assuit University, Assiut, Egypt
Abdallah Mohamed Taha, General Surgery Department, Faculty of Medicine, South Valley University, Qena, Egypt
Mahmoud Abdelhameid, General Surgery Department, Faculty of Medicine, South Valley University, Qena, Egypt
Ahmed Mohamed Ali Abdallah, General Surgery Department, Faculty of Medicine, Assuit University, Assiut, Egypt
Zein Sayed, Internal Medicine Department, Faculty of Medicine, Assuit University, Assiut, Egypt
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.
Mostafa Mohamoud Sayed,
Abdallah Mohamed Taha,
Ahmed Mohamed Ali Abdallah,
Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic, Journal of Surgery.
Vol. 5, No. 5,
2017, pp. 72-78.
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