Surgical versus endoscopic management of retained recurrent bile duct stones

ABSTRACT

Twenty patients with retained or recurrent bile duct stones were reviewed to compare the results of operative versus endoscopic therapy. Ten patients [two with T tube] underwent common bile duct exploration [CBDE] with T tube replacement or drainage procedure, while the remaining ten [five with T tube] underwent endoscopic sphincterotomy [ES] and stone extraction. There was no mortality. Success rates were similar for CBDE and ES. No complications occurred in groups managed endoscopically, while in the group treated operatively, duodenal fistula occurred in one case and superficial wound infection occurred in another case. Both complications were cured concervatively. Hospitalization was significantly shorter in groups managed by ES than those underwent CBDE. The conclusion is that the results of ES and CBDE are comparable and the use of ES should remain the procedure of choice for bile duct stones after cholecystectomy