Comparison of long-term follow-up results of open common bile duct exploration and laparoscopic common bile duct exploration in common bile duct stone disease

Abstract

Purpose: Currently, in treatment of symptomatic common bile duct (CBD) stone, the endoscopic retrograde cholagiopancreatography (ERCP) is usually carried out as an initial evaluation and removal of CBD stones. But, many cases necessitate surgical exploration of CBD and stone removal. Recently, laparoscopic CBD exploration (LCBDE) procedure is increasing due to the high success rate of stone clearance with the easy use of a choledochoscope and the advantage of less aggressive laparoscopic procedure properties. We reviewed the long-term results and efficacy of LCBDE in relation to traditional open CBDE results to demonstrate the superiority of LCBDE. Methods: From July 1997 until July 2007, 189 consecutive patients with CBD stones were enrolled in a retrospective study. Those patients were divided into two-groups: Laparoscopic CBDE (group L) and Open CBDE (group O), and compared the patients' clinical characteristics, postoperative outcomes and follow up data. Results: Of 189 patients who underwent successful CBD exploration, 66 (34.9%) were open group and 123 (65.1%) were laparoscopic group. Stone clearance rate was 100% in both groups. The mean operation time, incidence of postoperative complications and hospital days had no significant difference between the two groups (P>0.05). The cases of T-tube insertion and recurrence of CBD stone were significantly more in open group (P<0.05). Conclusion: On investigation of long-term follow up data of the two groups, CBD stone recurrence cases were significantly fewer in laparoscopic group. The lower incidence of complication and stone recurrence is evidence of the superiority of laparoscopic procedure in CBD exploration and removal of CBD stones.