Laparoscopic cholecystectomy with intraoperative endoscopic sphincterotomy and common bile duct exploration are each safe, effective and minimally invasive methods of treating cholecystocholedocholithiasis, according to data presented at the Society of American Gastrointestinal and Endoscopic Surgeons Annual Meeting in Baltimore.
Researchers conducted a prospective study and evaluated 274 patients with suspected common bile duct (CBD) stones between March 2008 and April 2012. All patients had been diagnosed with CBD stones via ultrasonography and magnetic resonance cholangiopancreatography.
Participants were randomly assigned to undergo laparoscopic cholecystectomy (LC) combined with either laparoscopic common bile duct exploration (LC-LCBDE; n=138) or intraoperative endoscopic sphincterotomy (LC-IOES; n=136). Outcomes were compared between groups.
Significantly more patients who received LC-IOES experienced pancreatitis and bleeding sphincterotomy. Those who received LC-LCBDE experienced bile leakage and retained CBD stones significantly more frequently than LC-IOES patients. No significant differences were observed regarding surgical success, length of hospital stay after the procedure or surgical time.
“Both LC-IOES and LC-LCBDE were shown to be safe, effective, minimally invasive treatments for cholecystocholedocholithiasis,” the researchers wrote, “but the former option may be preferred when facilities and experience for endoscopic therapy do exist.”
For more information:
Elgeidie AA. S099: Laparoscopic Common Bile Duct Exploration Versus Intraoperative Sphincterotomy for Management of Common Bile Duct Stones: A Prospective Randomized Trial. Presented at: the Society of American Gastrointestinal and Endoscopic Surgeons 2013 Annual Meeting; April 17-20, Baltimore.