The optimal management of patients with concomitant common bile duct stones and gallstones is still evolving. With the introduction of laparoscopic common bile duct exploration, many centers prefer single-stage laparoscopic cholecystectomy and common bile duct exploration over preoperative endoscopic bile duct clearance followed by laparoscopic cholecystectomy. The present study was done to compare these two management options.
Patients and methods30 patients with symptomatic gallstones and common bile duct stones were randomized to either treatment option. Preoperative endoscopic ultrasound (EUS) and/or magnetic resonance pancreaticography (MRCP) was done in all patients to confirm the diagnosis. In group I, laparoscopic cholecystectomy and common bile duct exploration was done at the same sitting; in group II, endoscopic stone clearance was followed by laparoscopic cholecystectomy 4–6 weeks later. Success was defined as successful treatment by the intended modality.
Results15 patients were randomized to each group and the two groups had comparable demographic and clinical profile. In group I there was a success rate of 93.5% in comparison with 86.7% in group II (p = 0.32, Fisher’s exact test). The complications were similar in the two groups.
ConclusionsThe results showed equivalent success rate in terms of morbidity and hospital stay. Laparoscopic approach seems to be favorable because of the smaller number of procedures and hospital visits.
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Authors Drs. Virinder Bansal, Mahesh Misra, Pramod Garg, and Manik Prabhu have no conflicts of interest or financial ties to disclose.
Author information Authors and AffiliationsDepartment of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5045, 5th Floor, Teaching Block, New Delhi, India
Virinder K. Bansal, Mahesh C. Misra & Manik Prabhu
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
Pramod Garg
Correspondence to Virinder K. Bansal.
About this article Cite this articleBansal, V.K., Misra, M.C., Garg, P. et al. A prospective randomized trial comparing two-stage versus single-stage management of patients with gallstone disease and common bile duct stones. Surg Endosc 24, 1986–1989 (2010). https://doi.org/10.1007/s00464-010-0891-7
Received: 27 June 2009
Accepted: 01 January 2010
Published: 05 February 2010
Issue Date: August 2010
DOI: https://doi.org/10.1007/s00464-010-0891-7
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