Journal of Surgery

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Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic

Received: 02 July 2017    Accepted: 11 July 2017    Published: 13 September 2017
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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.

DOI 10.11648/j.js.20170505.11
Published in Journal of Surgery (Volume 5, Issue 5, October 2017)
Page(s) 72-78
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Common Bile Duct Stones, Common Bile Duct Exploration, Endoscopic Retrograde Cholangio-Pancreatography, Endoscopic Sphincterotomy, Choledocholithiasis

References
[1] Sarli L, Pietra N, Franze A, Colla G, Costi R, Gobbi S, et al. Routine intravenous cholangiography, selective endoscopic retrograde cholangiography and endoscopic treatment of common bile duct stones before laparoscopic cholecystectomy. Gastrointest Endosc 1999; 50: 200-8.
[2] Collins C, Maguire D, Ireland A, Fitzgerald E, O'Sullivan GC. A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy: natural history of choledocholithiasis revisited. Ann Surg 2004; 239: 28-33.
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[4] Urbach DR, Khajanchee YS, Jobe BA, Standage BA, Hansen PD, Swanstrom LL. Cost-effective management of common bile duct stones: a decision analysis of the use of endoscopic retrograde cholangiopancreatography (ERCP), intraoperative cholangiography, and laparoscopic bile duct exploration. Surg Endosc 2001; 15: 4-13.
[5] Enochsson L, Lindberg B, Swahn F, Arnelo U. Intraoperative endoscopic retrograde cholangiopancreatography (ERCP) to remove common bile duct stones during routine laparoscopic cholecystectomy does not prolong hospitalization: a 2-year experience. Surg Endosc 2004; 18: 367-71.
[6] Sherman S, Hawes RH, Rathgaber SW, Uzer MF, Smith MT, Khusro QE, et al. Post-ERCP pancreatitis: randomized, prospective study comparing a low- and high-osmolality contrast agent. Gastrointest Endosc 1994; 40: 422-7.
[7] Rogers S J, Cello J P, Horn J K, Siperstein A E, Schecter W P, Campbell AR, et al. Prospective randomized trial of LC+LCBDE vs ERCP/S+LC for common bile duct stone disease. Arch Surg 2010; 145: 28-33.
[8] Cuschieri A, Croce E, Faggioni A, Jakimowicz J, Lacy A, Lezoche E, et al. EAES ductal stone study. Preliminary findings of multi-center prospective randomized trial comparing two-stage versus single-stage management. Surg Endosc 1996; 10: 1130-5.
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[11] Bago L, Vicente C, Soler F, Delgado M, Moral I, Guerra I, et al. Two-stage treatment with preoperative endoscopic retrograde cholangiopancreatography (ERCP) compared with single-stage treatment with intraoperative ERCP for patients with symptomatic cholelithiasis with possible choledocholithiasis. Endoscopy 2006; 38: 779-86.
[12] Hong DF, Xin Y, Chen DW. Comparison of laparoscopic cholecystectomy combined with intraoperative endoscopic sphincterotomy and laparoscopic exploration of the common bile duct for cholecystocholedocholithiasis. Surg Endosc 2006; 20: 424-7.
[13] Meyer C, Le Jacques VH, Rohr S, Duclos B, Reimund J, Baumann R. Management of common bile duct stones in a single operation combining laparoscopic cholecystectomy and perioperative endoscopic sphincterotomy. J Hepatobiliary Pancreat Surg 2002; 9: 196-200.
[14] Wright B, Freeman M, Cumming J, Quickel R, Mandal A. Current management of common bile duct stones: is there a role for laparoscopic cholecystectomy and intraoperative endoscopic retrograde cholangiopancreatography as a single stage procedure? Surgery 2002; 132: 729-37.
[15] Alexakis N, Connor S. Meta-analysis of one- vs. two-stage laparoscopic/ endoscopic management of common bile duct stones. HPB (Oxford) 2012; 14: 254-259.
[16] Dasari B V, Tan C J, Gurusamy K S, Martin D J, Kirk G, Mc Kie L, et al. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev 2013; 12: CD003327.
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Author Information
  • General Surgery Department, Faculty of Medicine, Assuit University, Assiut, Egypt

  • General Surgery Department, Faculty of Medicine, Assuit University, Assiut, Egypt

  • General Surgery Department, Faculty of Medicine, South Valley University, Qena, Egypt

  • General Surgery Department, Faculty of Medicine, South Valley University, Qena, Egypt

  • General Surgery Department, Faculty of Medicine, Assuit University, Assiut, Egypt

  • Internal Medicine Department, Faculty of Medicine, Assuit University, Assiut, Egypt

Cite This Article
  • APA Style

    Mostafa Mohamoud Sayed, Ayman Kamal, Abdallah Mohamed Taha, Mahmoud Abdelhameid, Ahmed Mohamed Ali Abdallah, et al. (2017). Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic. Journal of Surgery, 5(5), 72-78. https://doi.org/10.11648/j.js.20170505.11

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    ACS Style

    Mostafa Mohamoud Sayed; Ayman Kamal; Abdallah Mohamed Taha; Mahmoud Abdelhameid; Ahmed Mohamed Ali Abdallah, et al. Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic. J. Surg. 2017, 5(5), 72-78. doi: 10.11648/j.js.20170505.11

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    AMA Style

    Mostafa Mohamoud Sayed, Ayman Kamal, Abdallah Mohamed Taha, Mahmoud Abdelhameid, Ahmed Mohamed Ali Abdallah, et al. Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic. J Surg. 2017;5(5):72-78. doi: 10.11648/j.js.20170505.11

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  • @article{10.11648/j.js.20170505.11,
      author = {Mostafa Mohamoud Sayed and Ayman Kamal and Abdallah Mohamed Taha and Mahmoud Abdelhameid and Ahmed Mohamed Ali Abdallah and Zein Sayed},
      title = {Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic},
      journal = {Journal of Surgery},
      volume = {5},
      number = {5},
      pages = {72-78},
      doi = {10.11648/j.js.20170505.11},
      url = {https://doi.org/10.11648/j.js.20170505.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.js.20170505.11},
      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.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic
    AU  - Mostafa Mohamoud Sayed
    AU  - Ayman Kamal
    AU  - Abdallah Mohamed Taha
    AU  - Mahmoud Abdelhameid
    AU  - Ahmed Mohamed Ali Abdallah
    AU  - Zein Sayed
    Y1  - 2017/09/13
    PY  - 2017
    N1  - https://doi.org/10.11648/j.js.20170505.11
    DO  - 10.11648/j.js.20170505.11
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 72
    EP  - 78
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20170505.11
    AB  - 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.
    VL  - 5
    IS  - 5
    ER  - 

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