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Original Paper

Laparoscopic Exploration versus Intraoperative Endoscopic Sphincterotomy for Common Bile Duct Stones: A Prospective Randomized Trial

ElGeidie A.A. · ElShobary M.M. · Naeem Y.M.

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Gastroenterology Surgical Center, Mansoura University, Mansoura, Egypt

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Dig Surg 2011;28:424–431

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 20, 2011
Accepted: August 04, 2011
Published online: January 07, 2012
Issue release date: January 2012

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: https://www.karger.com/DSU

Abstract

Background/Aims: Laparoscopic cholecystectomy (LC) combined with intraoperative endoscopic sphincterotomy (IOES) was compared to LC with laparoscopic common bile duct exploration (LCBDE) to define the best single-session minimally invasive treatment for cholecystocholedocholithiasis. Methods: Between June 2009 and December 2010, patients with gallstones and common bile duct (CBD) stones diagnosed by preoperative ultrasonography and magnetic resonance cholangiopancreatography were randomized to LC-LCBDE or LC-IOES. The primary end point was complete clearance of CBD of stones. The secondary end points were operation time, conversion rate, length of hospital stay, complications and mortality. Results: Two hundred and twenty-six patients were eligible. They were randomized to LC-LCBDE (n = 115) and LC-IOES (n = 111). There was no statistically significant difference in the success rate of CBD clearance between the two interventions (92% for LC-LCBDE vs. 97.2% for LC-IOES with a p value >0.05). There were no differences between the two groups in terms of surgical time and postoperative length of stay. Pancreatitis and bleeding sphincterotomy were significantly more prevalent in the LC-IOES group, while bile leakage and retained CBD stones were significantly more prevalent in the LC-LCBDE group. Conclusion: Both LC-IOES and LC-LCBDE were shown to be safe, effective, minimally invasive treatments for cholecystocholedocholithiasis, but the former option may be preferred when facilities and experience in endoscopic therapy exist.

© 2012 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 20, 2011
Accepted: August 04, 2011
Published online: January 07, 2012
Issue release date: January 2012

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: https://www.karger.com/DSU


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