Concomitant ERCP and laparoscopic cholecystectomy for management of gallstones complicated by obstructive jaundice versus two sessions procedure comparative study, Minia university hospital experience

Abstract

Introduction: Choledocholithiasis is an important public health problem, since up to 18% of patients with cholelithiasis develop this complication of biliary lithiasis, stone extraction should be performed to avoid serious complications; the aim of this study is to compare one session procedure versus sequential sessions procedure for management of Choledocholithiasis.Patients and methods: This is a comparative clinical study that was done on 60 patients with combined gallbladder and CBD stones attending to Minia University Hospital of gastro enterology and hepatology between November 2021 and November 2022 surgery Patients were divided into two groups ,Group A:.30 of them were managed by one session procedure ,group: 30 patients was managed by sequential sessions procedure .Results:as regard number of ERCP and anesthesia sessions in both groups in group A mean number number was 1±0.0 in group B was 3,7±1.4 (p<0.001). In group (A), ERCP success rate (100%) , lap. Cholecystectomy failure rate 13.3% . In group (B), ERCP success rate 90%. lap cholecystectomy in failure rate 20% (p=0.024). The mean duration of hospital stay in group (A) was 2.0± 1.8 days and 7.0± 3.5 days in group (B) (p<0.001). as regard post-operative complications group A reported two cases pancreatitis while 13 cases in group (B) showed postoperative complications,(p=0.003). The mean cost of operation in group (A) was 32527± 11801 L.E and 55363± 20573 L.E in group (B), (p<0.001). Conclusion :- one session procedure was better than sequential sessions procedure as regard cost, hospital stay, and postoperative complication,