LCBDE a better Procedure than ERCP in cases of Common Bile Duct Diameter >10 mm

Abstract

Background: Choledocholithiasis and cholelithiasis are commonly diagnosed problem in adults in 4th-5th decade of life. Patients present with chief complaints of abdominal pain, nausea, vomiting, jaundice, where abdominal pain is the most common.
Methods: This prospective study was conducted in Department of General Surgery, G.S.V.M medical college, kanpur, India from January 1st 2018 to January 1st 2022. All the patients with choledocholithiasis, with stone diameter more than 10mm were included in the study.
Results: Success rate of stone clearance was same in both LCBDE and ERCP. With stone size more than 10mm was not able to retrieve by ERCP, so LCBDE was preferred. Hospital stay was more in LCBDE(4-5 days) ,as compared to ERCP(2 days), but when ERCP was accomapanied by cholecystectomy stay increased to 6 days. Complication rate of wound infection ,bilke leak are more in LCBDE group while in ERCP group pancreatitis, duodenal perforation and hemorrhage are more.
Conclusion: ERCP along with laparoscopic cholecystectomy gives patients the burden of two procedures ,hence more complication rate ,more postoperative stay ,twice exposure to anesthetic procedures and more costlier than LCBDE. Limitation in removal of stone more than 10mm in size, for which LCBDE is needed. With the improvement in laparoscopic technique and increasing expertise ,surgeons are comfortable with laparoscopic techniques of CBD surgery. A single procedure which could be performed by minimally invasive technique ,was an attractive proposition compared with multiple intervention. LCBDE with laparoscopic cholecystectomy becoming choice of treatment in expert hands.