Intraoperative ERCP and endoscopic sphincterotomy combined with laparoscopic cholecystectomy for treatment of cholelithiasis with choledocholithiasis |
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| Authors: | Gao Min Zhou Wen Shi Jian-ming Hong De-fei Mu Yi-ping Wang Jian-guo Wang Yao-dong |
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| Institution: | (1) Sir Run Run Shaw affiliated Hospital of Zhejiang University, 310016 Hangzhou, China |
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| Abstract: | Objective: To evaluate the benefit of intraoperative ERCP and endoscopic sphincterotomy (EST) combined with laparoscopic cholecystectomy
(LC) in the treatment of cholelithiasis with choledocholithiasis. Methods: Fifty-two patients with cholelithiasis and choledocholithiasis
(as determined by intraoperative cholangiography) were randomly divided into 2 groups during LC. In group A (27 patients),
common bile duct stones were extracted by intraoperative EST during LC. In group B(25 patients), common bile duct (CBD) stones
were extracted by conversion to open CBD exploration and cholecyctectomy. Results: The success rate was 26/27 (96.3%) in group
A and 25/25 (100%) in group B (0.25<P<0.5); The mean postoperative hospitalization was 3.32±0.56 days in group A and 17.5±4.61 days in group B (P<0.001). In group A, two cases were complicated transient hyperamylasemia after the combined procedure. In group B, one case
of bile leakage and one case of duodenal ulcer occurred after conversion to open cholecystectomy with CBD exploration. There
were no retained stones in group A but 2 cases in group B. Conclusion: Intraoperative ERCP and endoscopic sphincterotomy combined
with LC for treatment of cholelithiasis and chiledochlithiasis is safe, effective and results in shorter hospitalization and
fewer complications than traditional open cholecystectomy with CBD exploration. |
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| Keywords: | choledocholithiasis EST LC ERCP |
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