Comparing one-stage and two-stage treatment approach of cholelithiasis and choledocholithiasis
Bahtiyar Muhammedoglu1, Huseyin Kerem Tolan2
1Necip Fazıl City Hospital Gastroenterological Surgery Clinic, Kahramanmaraş, Turkey
2University of Health Sciences Ümraniye Training and Research Hospital General Surgery Department, Istanbul, Turkey
Aim: Complicated bile duct stones with choledocholithiasis may cause serious morbidity and mortality. The aim of this study was to evaluate; cost, frequency of the imaging methods used and the length of the hospital stay after the one-stage and two-stage procedures.
Material and Methods: Endoscopic Retrograde Cholangio Pancreatography (ERCP) and Laparoscopic Cholecystectomy (LC) was performed in 16 out of 250 LC cases and was named as Group A; other 12 patients have had interval LC 6-8 weeks after the ERCP procedure and were named as Group B. All ERCP and LC were performed by the same surgeon.
Results: The duration of hospitalization in Group A was 6 [4-9.5] days and was statistically significantly longer in the group B patients which was 8.5 [9.5-10.5] days (p <0.0470). The frequency of the use of the imaging methods was 3 [2-4.5] in Group A and 6 [4.5-7.0] in B (p <0.001). The cost of the procedures were significantly lower in the Group A compared to B (p <0.047) and was 2411.3 [1855.6-2819.9] and 2839.9 [2495.5-3237.1] Turkish Lira (TL) respectively.
Conclusion: Simultaneous ERCP and LC are safe and a feasible in selected cases and advantageous in terms of the total cost and the length of the hospital stay. There is need for more studies to clarify the timing of the surgical treatment after the ERCP.