A randomized controlled trial of emergency LCBDE + LC and ERCP + LC in the treatment of choledocholithiasis with acute cholangitis.
Wideochir Inne Tech Maloinwazyjne
; 17(1): 156-162, 2022 Mar.
Article
in En
| MEDLINE
| ID: mdl-35251401
ABSTRACT
INTRODUCTION:
Emergency biliary drainage is the basic treatment for acute cholangitis caused by choledocholithiasis.AIM:
To compare the effectiveness and safety of emergency laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy (LCBDE + LC) and endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy (ERCP + LC) for the treatment of choledocholithiasis combined with grade I or II acute cholangitis. MATERIAL ANDMETHODS:
A total of 80 patients were enrolled in the study, with 40 cases in each group. A prospective randomized controlled study method was adopted, and the eligible patients were randomly divided into two groups in a ratio of 1 1 and treated with emergency LCBDE + LC and ERCP + LC, respectively. The relevant clinical data of the two groups were compared.RESULTS:
The operation duration was longer and blood loss was greater in the LCBDE + LC group than in the ERCP + LC group, but the therapeutic cost was significantly lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all). There was no severe complication in either group. The total number of cases with complications, incidence of postoperative acute pancreatitis and incidence of hemorrhage were higher in the ERCP + LC group than in the LCBDE + LC group, while the incidence of bile leakage was lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all).CONCLUSIONS:
Both protocols were safe and feasible in the management of grade I or II acute calculous cholangitis. Compared with the protocol of ERCP + LC, the protocol of LCBDE + LC had the advantages of fewer complications and lower therapeutic costs and is worthy of clinical promotion.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Clinical_trials
/
Guideline
Language:
En
Journal:
Wideochir Inne Tech Maloinwazyjne
Year:
2022
Document type:
Article
Affiliation country:
China