Endoscopic Retrograde Cholangiopancreatography Versus Laparoscopic Transcystic Balloon Dilatation of Papilla Vateri in Patients with Choledocholithiasis
-
Published:2024-08-01
Issue:4
Volume:78
Page:311-316
-
ISSN:2255-890X
-
Container-title:Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.
-
language:en
-
Short-container-title:
Author:
Aleksandrovs Dmitrijs12, Ivanovs Igors123, Plaudis Haralds124, Fokins Vladimirs124, Kaminskis Aleksejs12
Affiliation:
1. Department of Emergency and General Surgery Latvia , Rīga East University Hospital Gailļezers , 2 Hipokrāta Str ., Rīga , , Latvia 2. Hepato-Pancreato-Biliary Unit , Rīga East University Hospital Gaiļezers , 2 Hipokrāta Str ., Rīga , , Latvia 3. Faculty of Medicine , University of Latvia , 3 Jelgavas Str ., Rīga , , Latvia 4. Faculty of Medicine , Rīga Stradiņš University Latvia , 16 Dzirciema Str ., Rīga , , Latvia
Abstract
Abstract
Two-step therapy, endoscopic retrograde cholangiopancreatography with papillotomy and stone evacuation from common bile duct (CBD), and laparoscopic cholecystectomy (ERCP/LC) is standard treatment of choledocholithiasis and acute cholecystitis in our hospital, Rīga East University Hospital Gaiļezers. The one-step method, LC with intraoperative transcystic balloon dilatation of the papilla Vateri and anterograde evacuation of gallstones to duodenum (BD/LC), has been introduced in our hospital. The aim of this study was to compare two-step and BD/LC methods and report the outcomes from hospital’s clinical experience. A retrospective, comparative study was done from 01.2021 to 10.2023. Patients with acute calculous cholecystitis and choledocholithiasis with gallstone diameter in CBD cm, ASA score I-III were included. Gallstone’s diameter and number, hospitalisation time, and success rate were analysed. A total of 95 patients were included in our study, of which 46 patients underwent BD/LC and in 49 patients ERCP/LC was used. Median diameter of gallstones in the CBD was 6.1 mm in BD/LC and 6.3 mm in the ERCP/LC group (p = 0.38). Median hospitalisation time for patients with single-step treatment was seven days, and two-step therapy — 14 days (p = 0.001). The complication rate in BD/LS was 4.34% but in ERCP/LC group — 10.2% after ERCP (p = 0.049). The success rate in BD/LC was 95.6% and in ERCP/LC group — 89.6% (p = 0.145). BD/LC is associated with a shorter hospitalisation time, similar success rate and lower complication rate compared with an ERCP/LC.
Publisher
Walter de Gruyter GmbH
Reference20 articles.
1. Atstupens, K., Mukans, M., Plaudis, H., Pupelis, G. (2020). The role of laparoscopic ultrasonography in the evaluation of suspected choledocholithiasis. A single-center experience. Medicina (Kaunas, Lithuania), 56 (5), 246. https://doi.org/10.3390/medicina56050246. 2. Boni, L., Huo, B., Alberici, L., Ricci, C., Tsokani, S., Mavridis, D., Amer, Y. S., Andreou, A., Berriman, T., et al. (2022). EAES rapid guideline: Updated systematic review, network meta-analysis, CINeMA and GRADE assessment, and evidence-informed European recommendations on the management of common bile duct stones. Surg. Endosc., 36 (11), 7863–7876. https://doi.org/10.1007/s00464-022-09662-4. 3. Bosley, M. E., Gaffley, M. W. G., Zeller, K. A., Sieren, L. M., Petty, J. K., Pranikoff, T., Neff, L. P. (2021). Balloon sphincteroplasty in pediatric laparoscopic common bile duct exploration. https://doi.org/10.1016/j.jpedsurg.2020.12.001. 4. Bosley, M. E., Nunn, A. M., Westcott, C. J., Neff, L. P. (2022). Antegrade balloon sphincteroplasty as an adjunct to laparoscopic common bile duct exploration for the acute care surgeon. J. Trauma Acute Care Surg., 92 (3), e47. https://doi.org/10.1097/TA.0000000000003478. 5. Chandrasekhara, V., Khashab, M. A., Muthusamy, V. R., ASGE Standards of Practice Committee (2017). Adverse events associated with ERCP. Gastrointest. Endosc., 85 (1), 32–47.
|
|