Comparative Study of Laparoscopic Common Bile Duct Exploration vs Open Method for the Treatment of CBD Stone

ABSTRACT

PURPOSE: To compare a laparoscopic common bile duct (CBD) exploration with the open method with regards to the clinical outcome in the treatment of a CBD stone. METHODS: A comparative study was performed on 88 patients who underwent surgical treatment for a CBD stone at Ewha Womans University Mokdong Hospital from February 1997 to December 2001. The patients were divided into three groups; a group treated by a laparoscopic CBD exploration (group L, n=59), a group treated by open surgery (group O, n=22), and a group converted to open surgery during laparoscopic treatment (group C, n=7). The medical records were reviewed, and the follow-ups study of the quality of life was assessed with a questionnaire on the symptoms associated with cholangitis. RESULTS: Among the 3 groups, there was no difference in the preoperative status of the patients (age, sex, preoperative comorbidity and previous abdominal operation history). The mean operating time were 230.7 minutes in group L, 182.0 minutes in group O, and 247.9 minutes in group C (P>0.05). The time to diet and hospital stay was longer in group C than the others (P<0.05). The postoperative complications were 10.5% in group L, 40.9% in group O and 14.3% in group C. The symptoms of cholangitis by the questionnaire during the follow-up period were 2.7% in group L, 33.3% in group O, and 66.7% in group C. CONCLUSION: Laparoscopic CBD exploration has acceptable operative difficulties, less morbidity, and good follow-up quality of life compared to the open method in treating CBD stones.