Davide Di Mauro1, Edoardo Ricciardi1, Leandro Siragusa2, Antonio Manzelli1. 1Royal Devon and Exeter NHS Foundation Trust, Exeter, UK, 2Tor Vergata University Hospital, Rome, Italy
Introduction: Common bile duct stones (CBDS) are treated with endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) or with the single-stage laparoscopic common bile duct exploration (LCBDE) and LC. Multiple ERCP attempts and failure increase the risk of post-procedural complications. In such circumstances surgery is advocated.
The aim of the study is to compare the outcome of LCBDE and LC in patients who had never had an ERCP, to that of patients who underwent previously failed ERCP.
Methods and Procedures: A retrospective analysis of 54 patients undergoing LCBDE and LC between 2010 and 2017, was performed. Patients were divided in 2 groups: primary surgery (group 1), surgery after failed ERCP (group 2). Demographics and preoperative investigations results were collected. Comparative outcomes were CBD clearance rate, operative time, conversion to open rate, postoperative morbidity, mortality, hospital stay. Student’s t-test was used for non-parametric data; two-tailed Chi-square or Fisher’s tests were used to compare differences in frequencies. Results were considered as statistically significant when p < 0.05.
Results: Results are shown in table 1 below:
No postoperative mortality was recorded.
Conclusions: LCBDE and LC is safe and effective in patients who had previous failed ERCP. If ERCP failure is anticipated and/or the risk of post-ERCP complications is high, surgery should be considered as the first line treatment of CBDS. Longer intraoperative time and hospital stay are expected.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93876
Program Number: P266
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster