Vietnam Journal of Science, Technology and Engineering (Sep 2018)

Gallstones and common bile duct stones: single or separatedstep endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy?

  • Nhu Hiep Pham,
  • Trung Vy Pham,
  • Huu Thien Ho,
  • Hai Thanh Phan,
  • Anh Vu Pham,
  • Nhu Nguyen Phuong Tran,
  • Ngoc Sang Ho,
  • Thanh Xuan Nguyen,
  • Tien Nhan Van,
  • Nghiem Trung Tran,
  • Xuan Dong Pham,
  • Trung Hieu Mai

DOI
https://doi.org/10.31276/VJSTE.60(3).55
Journal volume & issue
Vol. 60, no. 3

Abstract

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Purpose: the treatment of concomitant gallstones and common bile duct (CBD) stones by endoscopic retrograde cholangiopancreatography (ERCP) following laparoscopic cholecystectomy (LC). The analysis of single-step or separated-step characteristics. Object: during the three years (2015-2017), 68 patients having CBD stones concomitant gallstones suitable criteria for inclusion at Hue Central Hospital. Retrospective clinical description study. Results: the average age is 52.2±12.5 years (24-90) and the male/ female ratio is 0.7/1 (27/41). Abdominal pain was the most common symptom 91.2%, which was followed by jaundice 51.5%; direct bilirubin increased by 27.3±15.6 μmol/l (2.2-165). The size of CBD stones is 12.4±3.2 mm (6-20), the size of gallstones is 11.3±6.2 mm (5-36). The first time CBD stones 95.6%, recurrent CBD stones 4.4%. Single-step ERCP and LC 34 patients, separated-step group: ERCP 1.4±2.5 times and secondary LC. Single-step ductal clearance 76.5%, separated-step ductal clearance 94.1% (p=0.041). Length of hospital stay 6.5±4.3 days and 13.6±2.2 days (p<0.0001). Conclusions: the rate of ductal clearance in the separated-step group was significantly higher than the single-step group with p=0.041. The indication of laparoscopic cholecystectomy immediately ERCP should be based on the patient’s morbidity, the ductal clearance as well as the prognostic complications of ERCP.

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