Fifty patients with calcular obstructive Jaundice. 32 were females and
18 are males. Their ages ranged between 32-70 years Diagnosis was
achieved after proper clinical assessment, full set of laboratory investigations.
abdominal ultrasongraphy, and diagnostic E.R.C.P. Then, the patients
were randomized without any specifications into two equal groups:
A and B. Patients belonging to group (A) were managed by the traditional
open surgical procedure, while management of group B patients were
attempted by endoscopic sphincterotorny and stone extraction followed
two weeks later by laparoscopic cholecystectomy. In group (B) pat ferns.
after overcoming the different endoscopic difficulties encountered. complete
C.B.D clearance was achieved in 23 patients (9296) with two complications.
(8%) bleeding in one patient managed endoscopically and pancreatitis
in another one managed conservatively. The failed two cases
(8%) were managed by open surgery.
Laparoscopic cholecystectorny was attempted only in the 23 patients
with successful endoscopic C.B.D clearance. The difficulties encountered
were related to insufflation. dissection, control of bleeding, spillage of
stones, and extraction of stone-loden gall bladder. The procedure. Suc- |
