The efficacy of endoscopic and surgical management of CBD stones in terms of outcome, morbidity and mortality

Abstract

Laparoscopic Cholecystectomy has superseded open cholecystectomy as the preferred method. One limitation of laparoscopic cholecystectomy as preferred to open cholecystectomy is in dealing with common bile duct stones. Laparoscopic CBD exploration is time consuming, needs harder ware, is an intensive procedure, has steep learning curve and risks injury to Common bile duct. The data was collected in a proforma approved by the guide. The diagnosis was made with relevant clinical history, physical examination, relevant investigations-Liver function tests, ultrasound-abdomen, endoscopic retrograde cholangiogram, CT-scan abdomen. All patients were worked up for the therapeutic procedures with all routine lab investigations, ECG, chest Xray and fitness for the procedure was taken from the physicians where ever necessary. In this study of 60 patients, 34 patients had no complications. 3 patients had wound infection. In 4 patients along with wound infection cholangitis and sepsis (1 each), pancreatitis in one patient and bile leak in one patient was observed. Each of the 5patients had pancreatitis and sepsis. Cholangitis was observed in 3 patients and 2 patients had bile leak through t-tube tract following its removal which persisted for 6 and 7 days respectively. Cholangitis along with pancreatitis, sepsis, bile leak was observed in 1, 1, 2 patients respectively.