A Comparative Study between ERCP Stone Removal vs. Open CBD Exploration in Management of Choledocholithiasis

Author(s): Anindita Bhar1 , Sagar Karmakar2

BACKGROUND Common bile duct stones (choledocholithiasis) generally lead to several health problems such as pain, jaundice, infection, acute pancreatitis etc. For which it needs surgical intervention. We conducted this study to compare success and complication rate between ERCP stone removal and open CBD exploration. METHODS A total of 50 patients were selected from those attending Department of Surgery of KPC Medical College and were divided in two groups randomly, with 25 patients in each group. Group I patients underwent ERCP stone removal while those in Group II were subjected to open CBD exploration. Both the groups were compared on the basis of their success and complication rate, time taken for the procedure, time taken to return to work, and duration of hospital stay. RESULTS A total of 50 patients were selected, with mean age being 37.5 ± 11.71 yrs., 62% were female and 38% male. In Group I success rate was 92% and in Group II it was 96%. Complication rate was significantly more (p=.032504) in Group II (45.83%) compared to that in Group I (13.04%). Time taken for the procedure in Group I (36.09 ± 6.39 mins) was much less than that in Group II (120.63 ± 11.92 mins). Mean duration of hospital stay in group I was 2.91 ± 1.08 days while in Group II it was 11.79 ± 1.58 days. 8.35 ± 1.61 days were taken to return to work in Group I compared to 20.53 ± 1.95 days in Group II. CONCLUSIONS This comparative study of CBD stone removal is a small endeavour on our part to assess the advantages of ERCP stone removal. With appropriate infrastructure ERCP stone removal carries a greater advantage compared to that by open surgery.