Laparoscopic cholecystectomy (LC) prior versus post ERCP, in one session management of cholecysto-choledocholithiasis, randomized clinical controlled trial

Abstract

Introduction:Gallstones and common bile duct (CBD) stones are a significant issue. The consequences of leaving CBD stones untreated can be serious.Therefore,it is advisable to identify and treat choledocholithiasis simultaneously with cholecystectomy.The objective of this study is to compare the outcomes of performing LC followed by ERCP in a single session,with the outcomes of doing ERCP followed by LC in a single session. Patients and methods:This is a prospective clinical trial that was done on 60 patients with combined gall bladder and CBD stones.Patients were divided into two groups;Group A underwent LC followed by ERCP and group B underwent ERCP followed by LC. Results:As regard intra-operative data between both groups,the results were statistically significant regarding duration of procedure and convergence into open, as mean duration of procedure was significantly lower in group A(48.3±21.1 min)than in group B (77.1±26.7 min),also a significantly reduced convergence into open in group A(0%)than in group B (26.7%).As regard postoperative data and complication,the results were non-statistically significant regarding post-operative complication,however the incidence of pancreatitis was slightly higher in group B(13.3% for both items separately)than in group A(6.7% for both items separately).On the other hand,there is statistically significant difference between both groups regarding hospital stay as the mean was significantly higher in group B(3.6 days)than in group A(2.4 days). Conclusion:Doing same session LC followed by ERCP is superior to same session ERCP followed by LC as regards Operative time, conversion to open, incidence of complications and hospital stay