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Comparison of Secondary Non-Critical Acute Cholangitis After Phase I Laparoscopic Common Bile Duct Exploration and Endoscopic Stone Therapy for Common Bile Duct

Author(s): Yanjun Wang, Gaoxiong Wang, Tiancong Huang, Wenrui Zhou, Xinfeng Li


Objective: To compare the clinical effect of phase I laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration (LC + LCBDE) and cndoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy (ERCP + LC) on non-severe acute cholangitis secondary to common bile duct stones.

Methods: The clinical data of 132 cases of non-acute acute cholangitis secondary to common bile duct stones treated in the Second Affiliated Hospital of Fujian Medical University from January 2014 to December 2016 were retrospectively analyzed. The patients were divided into two groups according to different surgical methods: ERCP + LC group with 65 patients and LC+LCBDE group with 67 patients. The relevant clinical indicators of the two groups were compared. Results: There was no statistical difference in the other general data between the two groups (P > 0.05), except for that the mean age of the ERCP + LC group was greater than that of the LC + LCBDE group (P = 0.000) and the ERCP + LC group had a higher proportion of concomitant diseases than the LC + LCBDE group (P = 0.000). There was no significant difference in postoperative complication rate, residual rate of stone, mean surgical blood loss and postoperative gallbladder pathological type between the two groups (P > 0.05). The incidence of postoperative cholecosis in the LC + LCBDE group was significantly higher than that in the ERCP + LC group. There was no significant difference in postoperative pancreatitis and incidence of pulmonary infection (P > 0.05). Compared with the LC + LCBDE group, the operative time of the ERCP + LC group (P = 0.000) and postoperative peritoneal drainage time (P = 0.000) was shorter, there was no significant difference in postoperative hospital stay (P > 0.05). Conclusion: The first-stage of LC + LCBDE is safe and effective in the treatment of non-acute cholangitis secondary to common bile duct stones, which is the same as staging ERCP + LC, thus the individual treatment options can be selected according to the patient’s condition.