Comparison of endoscopic retrograde cholangiopancreatography then laparoscopic cholecystectomy and laparoscopic common bile duct exploration in patients with common bile duct stones

Background
Choledocholithiasis is concomitant with gallstones in ∼3–10% of patients. In the pre-endoscopic and prelaparoscopic era, the standard treatment for patients suffering from gallstones accompanied with common bile duct stones (CBDS) was open cholecystectomy and common bile duct (CBD) exploration. With the advent of laparoscopic and endoscopic techniques, several alternative treatments, such as laparoscopic cholecystectomy (LC), preoperative or postoperative endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and laparoscopic common bile duct exploration (LCBDE), have been developed to treat cholelithiasis. The management of stones in the CBD in the laparoscopic era is controversial. The aim of this study was to compare the efficacy, safety, and surgical outcomes of the LCBDE and ERCP with sphincterotomy, in patients with CBDS.
Patients and methods
The study was performed on 60 patients suffering from CBDS who were admitted and treated in our department in Al-Zahra Hospital and Al-Ameen Hospital, KSA between January 2014 and January 2016. The patients were divided into two groups according to the method of treatment. Group A included 20 patients who were treated by LCBDE whereas group B included 40 patients were treated by ERCP with sphincterotomy.
Results
This study was carried out on 60 patients with CBD stones. The patients were divided into two groups according to the method of treatment. Group A included 20 patients who were treated by LCBDE, whereas group B included 40 patients who were treated by ERCP with sphincterotomy.
Conclusion
The optimal management of patients with CBDS should depend on the condition of the patients, and the expertise of the operators. LCBDE is a feasible, safe, and effective procedure that carries low morbidity and mortality and will decrease the need for unnecessary ERCP in the future for suspected or proved choledocholithiasis.