Efficiency of laparoscopic vs endoscopic management in cholelithiasis and choledocholithiasis. Is there any difference?

• Published in: Cirugia y cirujanos Vol. 85; no. 4; p. 306
• Main Authors: Herrera-Ramírez, María de Los Angeles, López-Acevedo, Hugo, Gómez-Peña, Gustavo Adolfo, Mata-Quintero, Carlos Javier
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01.07.2017
• Subjects: Colecistectomía laparoscópica; Coledocolitiasis; Laparoscopic cholecystectomy; Choledocholithiasis; Colangiopancreatografía retrógrada endoscópica; Exploración de vía biliar laparoscópica; Surgery; Cholangiopancreatography endoscopic retrograde; Cirugía; Colelitiasis; Cholelithiasis; Laparoscopic common bile duct exploration
• ISSN: 2444-054X
• DOI: 10.1016/j.circir.7016.10.008

Concomitant cholelithiasis and choledocholithiasis is a disease where incidence increases with age and can have serious complications such as pancreatitis, cholangitis and liver abscesses, but its management is controversial, because there are minimally invasive laparoscopic and endoscopic surgical procedures. To compare the efficiency in the management of cholelithiasis and choledocholithiasis with laparoscopic cholecystectomy with common bile duct exploration vs cholangiopancreatography endoscopic retrograde+laparoscopic cholecystectomy. Retrospective analysis of a five year observational, cross sectional multicenter study of patients with cholelithiasis and concomitant high risk of choledocholithiasis who were divided into two groups and the efficiency of both procedures was compared. Group 1 underwent laparoscopic cholecystectomy with common bile duct exploration and group 2 underwent cholangiopancreatography endoscopic retrograde+laparoscopic cholecystectomy. 40 patients, 20 were included in each group, we found p=0.10 in terms of operating time; when we compared hospital days we found p=0.63; the success of stone extraction by study group we obtained was p=0.15; the complications presented by group was p=0.1 and the number of hospitalizations by group was p ≤ 0.05 demonstrating statistical significance. Both approaches have the same efficiency in the management of cholelithiasis and choledocholithiasis in terms of operating time, success in extracting stone, days of hospitalization, postoperative complications and conversion to open surgery. However the laparoscopic approach is favourable because it reduces the number of surgical anaesthetic events and the number of hospital admissions.