One-staged laparoscopic cholecystectomy and common bile duct exploration versus two-staged endoscopic stone extraction followed by laparoscopic cholecystectomy for concomitant cholecystolithiasis and choledocholithiasis
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R657.4

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    Abstract:

    Objective: To compare the clinical efficacy of single-staged laparoscopic cholecystectomy (LC) and common bile duct exploration (LCBDE) with two-staged endoscopic retrograde cholangiopancreatography (ERCP) followed by LC in treatment of concomitant gallbladder stones and common bile duct stones. Methods: The clinical data of 112 patients with concomitant gallbladder stones and common bile duct stones, who underwent minimally invasive surgical treatment in the First Affiliated Hospital of Xian Jiaotong University from January 2013 to June 2014, were retrospectively analyzed. Of the patients, 52 cases received single-staged LC plus LCBDE (LCBDE group), and 60 cases underwent two-staged ERCP followed by LC 24 h later or elective LC (ERCP group), and the main clinical variables between the two groups of patients were compared. Results: Except for the average age in LCBDE group was younger than that in ERCP group (42.4 years vs. 57.4 years, P<0.05), all the other data between the two groups were comparable. No death occurred in either group, and no significant difference was noted in surgical success rate (94.3% vs. 98.4%), overall incidence of complications (8.2% vs. 10.1%) and residual stone rate (2.0% vs. 1.7%) between the two groups (all P>0.05). The incidence of hyperamylasemia was significantly higher in ERCP group than that in LCBDE group (16.9% vs. 4.1%, P<0.05), but all were transient amylase elevations. In LCBDE group compared with ERCP group, the length of postoperative hospital stay was shorter (4.9 d vs. 6.3 d) and total hospitalization cost was reduced (21 685.9 yuan vs. 30 354.3 yuan), but the operative time was prolonged (117.1 min vs. 97.4 min) (all P<0.05). Conclusion: Both single-staged LC plus LCBDE and two-staged ERCP plus LC are safe and effective in treatment of concomitant gallbladder stones and common bile duct stones, and either of them can be selected according to the individual patient’s condition.

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LI Yu, HAO Jie, SUN Hao, WANG Lin, WU Zheng, WANG Zheng, TAO Jie, YANG Xue. One-staged laparoscopic cholecystectomy and common bile duct exploration versus two-staged endoscopic stone extraction followed by laparoscopic cholecystectomy for concomitant cholecystolithiasis and choledocholithiasis[J]. Chin J Gen Surg,2016,25(2):202-208.
DOI:10.3978/j. issn.1005-6947.2016.02.008

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History
  • Received:December 15,2015
  • Revised:January 18,2016
  • Adopted:
  • Online: February 15,2016
  • Published: