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Laparoscopic common bile duct exploration versus ERCP/stenting and cholecystectomy: Is a single staged procedure better?
Raju Kadam1, Dhananjay Saxena2, Arun Singh Rana1, Sanjeev Chhabra1, Zeeshan Ahmed1, Vikesh Vij1, Jeevan Kankaria3, Raj Kamal Jenaw4
1MBBS, MS (Std.), PG Resident, Department of General Surgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.
2MBBS, MS, Senior Resident, Department of General Surgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.
3MBBS, MS, Associate Professor, Department of General Surgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.
4MBBS, MS, Senior Professor and Head of the Department, Department of General Surgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.

Article ID: 100055IJHPDRK2016
doi:10.5348/ijhpd-2016-55-OA-11

Address correspondence to:
Raju Kadam
Room No. C-22, Resident Doctors' Hostel
Sawai Man Singh Medical College
Jaipur, Rajasthan
India - 302004

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How to cite this article
Kadam R, Saxena D, Rana AS, Chabra S, Ahmed Z, Vij V, Kankaria J, Jenaw RK. Laparoscopic common bile duct exploration versus ERCP/stenting and cholecystectomy: Is a single staged procedure better? Int J Hepatobiliary Pancreat Dis 2016;6:57–63.


Abstract
Aims: Choledocholithiasis is most common cause of obstructive jaundice. Laparoscopic choledocholithotomy has evolved as an alternative procedure to ERCP/ stenting in the management of choledocholithiasis. This study was aimed to compare the outcomes of laparoscopic CBD exploration with cholecystectomy (group 1) as compared to the conventional two staged procedure involving ERCP/ stenting (group 2).
Methods: 60 patients admitted to our department (mean age = 45.52, SD = 17.71, 15 males, 45 females) for the management of choledocholithiasis from April 2014 to October 2015 were included in the study. We reviewed retrospectively the patients' data including age, sex, duration of the surgery, intra-operative and postoperative complications, duration of hospital stay, mortality and condition on follow-up.
Results: Group 1 included 30 patients (mean age 50.76, 21 females, 9 males). The average operative time in this group was 110 minutes (96–145), stone clearance rate was 100%, and average hospital stay was 3.2 days (2–9). Group 2 also included 30 patients (mean age 44.36, 24 females, 6 males) with stone clearance rate of 70% (21 out of 30), average operative time 120.7 minutes (90–167), average hospital stay 9.1 (3–30) days and an average of 2.3 procedures per patient.
Conclusion: In our study mean operative time, stone clearance rate, average hospital stay and average number of procedures per patient were found to be significantly lower in laparoscopic CBD exploration group. It can be concluded that laparoscopic CBD exploration with cholecystectomy is much safer and cost effective than the conventional two staged procedure involving ERCP/ stenting.

Keywords: Cholangiopancreatography, Choledocholithiasis, Common bile duct, Endoscopic Retrograde, Laparoscopic, Outcomes


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Author Contributions:
Raju Kadam – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Dhananjay Saxena – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rana Arun Singh – Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Sanjeev Chhabra – Acquisition of data, Drafting the article, Final approval of the version to be published
Zeeshan Ahmed – Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published
Vikesh Vij – Acquisition of data, Drafting the article, Final approval of the version to be published
Jeevan Kankaria – Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Raj Kamal Jenaw – Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Raju Kadam et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.