The selection of endoscopic method for treatment of common bile duct stones / 中国普通外科杂志

ABSTRACT

Objective To explore the appropriate operative methods for the treatment of CBD(common bile duct) stone in endoscopic era.Methods We retrospectively analyzed the diagnosed and treated data of 309 patients with suspected CBD stones with ERCP,LC+ERCP and LECBD(laparoscopic exploration of the commonbile duct) from January 2004 to July 2008 in our hospital.Results A total of 216 patients receivedERCP,among them 97(44.9%) cases had CBD stone,and there was the trend that the number of patients who received ERCP reduced yearly.Among the 93 patients who received LECBD,71 cases were successful and 22 cases were converted to open operation.Of the 71 cases,transcystic duct CBD exploration was done in 11 cases,direct CBD exploration in 60 cases,and 6 cases had primary closure of CBD.The number of cases that received LECBD grew steadily with time.There was no difference in successful operative rate,intraoperative bleeding and residual calculi rate between ERCP+LC and LECBD group.The operative time,postoperative complications and length of hospital stay in LECBD.group were significantly lower than those in LC+ERCP group.Conclusions LECBD is better than LC+ERCP in the treatment of CBD stones,but in the endoscopic era,the selection of an individualized treatment approach is the best operative method for the management of CBD stone.