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>Journals >Cirujano General >Year 2017, Issue 2


Barba VCT, Barba VLA, Gaitán MCM, López RJL
Management of cholecystcholedocholithiasis: preoperative versus transoperative endoscopic retrograde cholangiography in Hospital Miguel Hidalgo in Aguascalientes
Cir Gen 2017; 39 (2)

Language: Español
References: 27
Page: 93-100
PDF: 4. Kb.


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ABSTRACT

Introduction: Currently there are different diagnostic and therapeutic strategies to treat cholecystcholedocholithiasis; there is no consensus on the ideal therapeutic approach. The aim of this study was to compare the results of endoscopic examination and simultaneous laparoscopic cholecystectomy with endoscopic retrograde cholangiopancreatography (ERCP) prior to laparoscopic cholecystectomy. Material and methods: Ambispective and comparative study. Patients underwent preoperative ERCP, and patients with simultaneous ERCP and laparoscopic cholecystectomy were included. Two groups were created: control (patients undergoing ERCP prior to laparoscopic cholecystectomy) and study (patients with ERCP and laparoscopic cholecystectomy in the same surgical time). Demographic and biochemical variables, hospital stay, morbidity and mortality were analyzed. Results: We included a total of 98 patients, 68 in the control group and 30 in the study group. The failed ERCP rate was 5.9% (n = 4) in the control group and 3.3% (n = 1) in the study group. (p = 0.59). We registered complications in 22.4% (n = 22) of the total population: seventeen patients (17.3%) in the control group and five (5.1%) in the study group (p = 0.3). In the control group, mean hospital stay was 7.3 days (3-39 days), and in the study group, 5.3 days (2-11 days) (p = 0.5). Conclusion: The simultaneous exploration of the bile duct with ERCP laparoscopic cholecystectomy provides an opportunity for definitive treatment of cholecystcholedocholithiasis. It offers the possibility of definitive treatment in a same surgical and anesthetic time.


Key words: Cholecystolithiasis, choledocholithiasis, endoscopic retrograde reatography.


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