Impact of Minimal Invasive Surgery on Management of Choledocholithiasis
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This prospective randomized study was designed to compare the outcome of intraoperative laparoscopic common bile duct (LCBD) stone clearance versus postoperative endoscopic retrograde cholangiopancreatography (ERCP) clearance. The study comprised 30 patients; 17 (56.7%) females and 13 (43.3%) males, with mean age 47.1±11.6. The patients were assigned into two groups; Group A (n=15) received single stage laparoscopic management and group B (n=15) received laparoscopic clwlecystectorny followed by postoperative ERCP within 48-72 hours. The mean operative time was significantly longer in group A (153.4±19.3 minutes) compared to that recorded in group 8(104±111), Bile leak occurred in 1(6.7%) patient in group A, biochemical pancreatitis occurred in 1(6.7%) patient in group B, mild hemorrhage occurred in 1(6.7%) patient in group B. No cases in either group had retained stones during the follow up period. The mean hospital stay was (6.2±1.3) days in group A and (7.3±1.5) in group B. There was no significant difference in both management options regarding the morbidity; however LCBD exploration has the advantages of being a single-stage procedure with significant decrease in the hospital stay.