Open Surgery versus Endoscopic Intervention in the Management of Bile Duct Stones
Alghamdi, B., Sind, O., Rajab, W., Alzahrani, S., Alrayes, H., Moshref, L., Al Jabri, N., Al yami, M., Alsbhani, W., Al-Ghuraybi, S., Alasmari, M. (2017). Open Surgery versus Endoscopic Intervention in the Management of Bile Duct Stones. EKB Journal Management System, 67(2), 705-712. doi: 10.12816/0037825
Bayan Saeed A Alghamdi; Omar Abdulelah Sind; Wahhaj Hani Rajab; Saeed Hamed Alzahrani; Hezab Abdulrahman T Alrayes; Leena Hatem Moshref; Nibras Khaled Al Jabri; Mana abdullah saud Al yami; Wafaa Mohammed Alsbhani; Shaima Mohammed Al-Ghuraybi; Mohammed Hundur Alasmari. "Open Surgery versus Endoscopic Intervention in the Management of Bile Duct Stones". EKB Journal Management System, 67, 2, 2017, 705-712. doi: 10.12816/0037825
Alghamdi, B., Sind, O., Rajab, W., Alzahrani, S., Alrayes, H., Moshref, L., Al Jabri, N., Al yami, M., Alsbhani, W., Al-Ghuraybi, S., Alasmari, M. (2017). 'Open Surgery versus Endoscopic Intervention in the Management of Bile Duct Stones', EKB Journal Management System, 67(2), pp. 705-712. doi: 10.12816/0037825
Alghamdi, B., Sind, O., Rajab, W., Alzahrani, S., Alrayes, H., Moshref, L., Al Jabri, N., Al yami, M., Alsbhani, W., Al-Ghuraybi, S., Alasmari, M. Open Surgery versus Endoscopic Intervention in the Management of Bile Duct Stones. EKB Journal Management System, 2017; 67(2): 705-712. doi: 10.12816/0037825

Open Surgery versus Endoscopic Intervention in the Management of Bile Duct Stones

The Egyptian Journal of Hospital Medicine
Article 25, Volume 67, Issue 2, April 2017, Page 705-712  XML PDF (300.68 K)
Document Type: Original Article
DOI: 10.12816/0037825
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Authors
Bayan Saeed A Alghamdi1; Omar Abdulelah Sind1; Wahhaj Hani Rajab2; Saeed Hamed Alzahrani3; Hezab Abdulrahman T Alrayes4; Leena Hatem Moshref5; Nibras Khaled Al Jabri2; Mana abdullah saud Al yami3; Wafaa Mohammed Alsbhani1; Shaima Mohammed Al-Ghuraybi6; Mohammed Hundur Alasmari3
1Ibn Sina national College
2Umm alqura university
3Najran University
4Aljouf university
5King Abdulaziz university
6Battarjee medical colleges
Abstract
Background: Choledocholithiasis or the presence of common bile duct stones (CBDS) is one of the medical conditions that requires surgical intervention. The management of choledocholithiasis has evolved from open common bile duct exploration (OCBDE) to therapeutic endoscopic retrograde cholangiopancreatography (ERCP) to laparoscopic common bile duct exploration (LCBDE). Each entails a degree of difficulty. In this review we aim toassess and compare the benefits and pitfalls of open surgery (OCBDE) versus endoscopic retrograde cholangiopancreatography (ERCP) in management of common bile duct stones.
Methods: A systematic review of the electronically searched publications of the scientific literature. We searched the Cochrane HepatoBiliary Group Controlled Trials Register, Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE (1946 to 2016), EMBASE (1974 to 2016), and Science Citation Index Expanded (1900 to 2016).  Initially all randomized clinical trials which compared the results from open surgery versus endoscopic clearance for common bile duct stones were included, articles were selectively screened according to the eligibility criteria.
Results: eight publications were selectively included with 761 participants compared to open surgical clearance with ERCP. All trials had a high risk of bias. There was no significant difference in the mortality between open surgery versus ERCP clearance (eight trials; 733 participants; 5/371 (1%) versus 10/358 (3%) OR 0.51;95% CI 0.18 to 1.44). Neither was there a significant difference in the morbidity between open surgery versus ERCP clearance (eight trials; 733 participants; 76/371 (20%) versus 67/358 (19%) OR 1.12; 95% CI 0.77 to 1.62). Participants in the open surgery group had significantly fewer retained stones compared with the ERCP group (seven trials; 609 participants; 20/313 (6%) versus 47/296 (16%) OR 0.36; 95% CI 0.21 to 0.62), P = 0.0002. Meta-analysis of the outcomes duration of hospital stay, quality of life, and cost of the procedures could not be performed due to lack of data.
Conclusion: open surgery intervention in order to remove the gallbladder and trapped gallstones appears to be as safe as endoscopy and further suggested to be more successful than the endoscopic technique in clearing the duct stones.
 
Keywords
CBDS; bile duct stones; gallstones; Choledocholithiasis; Cholecystectomy; ERCP
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