Comparison between laparoscopic and conventionaltechnique in the surgical treatment of choledocholithiasis

Abstract

Öz: Introduction: The aim of the study is to compare f conventional and laparoscopic techniques in common bile duct exploration in terms of efficacy and safety.Materials and Methods: The data of 280 patients who underwent surgical procedure for common bile duct stones between January 2011 and December 2016 were retrospectively analyzed. This was an Ethics Committee-approved retrospective analysis of data between 2011 and 2016. The patients were divided into two groups according to the common bile duct exploration technique: laparoscopic (Group 1, 164 patients) and conventional (Group 2, 116 patients). The two groups were compared in terms of surgical findings and short-term results.Results: 170 (60.7%) of the patients were women. The mean age was 61.9±16.9 years. Clinical results showed that the operative time (120±35.9 vs 169±48.4 minutes, p<0.01) and hospital stay (6.3±3.9 vs 10.9±6.8 days, p<0.01) were shorter in Group 1; overall morbidity (9% vs 24%, p<0.01) and mortality rates (1.2% vs 6%, p<0.03) were lower. Postoperative endoscopic sphincterotomy requirement was less (7% vs 18.1%, p <0.01). In addition, in Group 1, there was a higher rate of stone clearance (93.9% vs 82.8%, p<0.01) with a lower rate of wound infection (0.6% vs 10.3%, p<0.01). No difference was observed in terms of re-operation, bile leakage or drain dislocation.Conclusion: In terms of stone clearance, hospital stay, morbidity, mortality and complication rates, laparoscopic common bile duct exploration is a significantly safer and more effective method compared to conventional exploration.