Management of concomitant gallbladder and common bile duct stones: one stage versus two stages | ||||
| The Egyptian Journal of Surgery | ||||
| Article 16, Volume 42, Issue 3, July 2023 PDF (888.09 K) | ||||
| DOI: 10.4103/ejs.ejs_137_23 | ||||
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| Authors | ||||
| Hossam Mahmoud Ibrahim Mohamed; Abd Elmoniem Mohamed Ismail Elkatieb; Ahmed Mohamed Ali Abdallah; Mahmoud Hasab Elnabi Abd Elrazik | ||||
| Abstract | ||||
| Background The ideal management plan for patients diagnosed with concomitant cholelithiasis and choledocholithiasis has been a great matter of debate among hepatobiliary surgeons. Some surgeons prefer a single-stage approach (laparoscopic cholecystectomy LC with laparoscopic common bile duct exploration, LCBDE), while others prefer two-stage approaches (preoperative endoscopic stone extraction followed by interval LC). Herein, we compare the outcomes of the previous two approaches in our Egyptian tertiary care setting. Methods Sixty-four patients were eligible for our randomized trial and were randomly assigned into two groups: Group A was scheduled for the single-stage approach and Group B was scheduled for the two-stage approach. Periprocedural outcomes, including success rates, were assessed in the two groups. Results Failed stone extraction was encountered in three patients in Group B (success rate 90.62%). However, we were able to completely free the CBD in all patients in Group A (100% success). Operative time was significantly prolonged in Group A (173.13 vs. 75.97 min in Group B). However, Group A patients had a shorter hospitalization period compared with Group B (5 vs. 7 days). Bile leakage was more encountered in Group A, while the incidence of pancreatitis was higher in Group B. All patients were conservatively managed with no further intervention. Conclusion A higher, but not statistically significant, success rate was reported with the single-stage approach. Despite this, this technique was preferred due to a shorter hospital stay and higher clearance rates reported in our study. | ||||
| Keywords | ||||
| Choledocholithiasis; Cholelithiasis; Single stage; Two Stages | ||||
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