Comparison Between Laparoscopic And Conventional Technique In The Surgical Treatment Of Choledocholithiasis

Abstract

Introduction:The aim of the study is to compare f conventional and laparoscopic techniques in common bile duct exploration in terms of efficacy and safety. Materials and Methods:The data of 280 patients who underwent surgical procedure for common bile duct stones between January 2011 and December 2016 were retrospectively analyzed. This was an Ethics Committee-approved retrospective analysis of data between 2011 and 2016. The patients were divided into two groups according to the common bile duct exploration technique: laparoscopic (Group 1, 164 patients) and conventional (Group 2, 116 patients). The two groups were compared in terms of surgical findings and short-term results.Results: 170 (60.7%) of the patients were women. The mean age was 61.9±16.9 years. Clinical results showed that the operative time (120±35.9 vs 169±48.4 minutes, p<0.01) and hospital stay (6.3±3.9 vs 10.9±6.8 days, p<0.01) were shorter in Group 1; overall morbidity (9% vs 24%, p<0.01) and mortality rates (1.2% vs 6%, p<0.03) were lower. Postoperative endoscopic sphincterotomy requirement was less (7% vs 18.1%, p <0.01). In addition, in Group 1, there was a higher rate of stone clearance (93.9% vs 82.8%, p<0.01) with a lower rate of wound infection (0.6% vs 10.3%, p<0.01). No difference was observed in terms of re-operation, bile leakage or drain dislocation. Conclusion:In terms of stone clearance, hospital stay, morbidity, mortality and complication rates, laparoscopic common bile duct exploration is a significantly safer and more effective method compared to conventional exploration.

Endoskopik olarak tedavi edilemeyen koledok taşlarında koledokoduodenostomi. Hem geleneksel hem de güncel yöntem

“…Currently, the standard treatment for CBD stones is the laparoscopic cholecystectomy following extracting the stones via endoscopic retrograde cholangiopancreatography (ERCP) [3,4]. However, in ERCP failed cases, other treatment methods should be performed [5]. Choledochoduodenostomy (CDD) is one of these, and despite increasing surgical experience, it has been maintaining its safety area for many years.…”