Comparing Two Stages Using Endoscopic Retrograde Cholangiopancreatography Procedures Versus One-Stage Laparoscopic Management for Concomitant Gallstones and Common Bile Duct Stones

Background: Almost all repetitive cause of obstructive jaundice is common bile duct (CBD) stones. Although several
alternatives exist the best plan is still unknown. These include endoscopic retrograde cholangiopancreatography (ERCP)
before, during, or following laparoscopic cholecystectomy (LC), open or laparoscopic surgical investigation. The study
compares the results of one- step laparoscopic technique common bile duct exploration (LCBDE+LC) versus two-step
(ERCP then LC) for management of contemporaneous gallstones and CBD stones in terms of mortality rates, hospital
stays, intra and postoperative complications, conversion to another procedure, and retained stones.
Patients and Methods: A total of 200 individuals with concurrent gallstones and CBD are included in this randomized
trial. Eligible patients were randomly allocated to one group to undergo either one-stage or two-stage therapy using
sealed envelopes: group I (n= 100): Patients received LCBDE+LC in a single-stage either transcholedochal (n= 70) or
transcystic (n= 30) procedures. Group Π (n= 100): During a single hospital stay, patients had ERCP+LC.
Results: With no discernible variation by sex, the mean age (years) for group I and group II was 43.16±12.66 and
41.52±9.44 years, respectively. 86 participants in group II and 88 individuals in group I had preoperative jaundice. The
two groups’ surgical times are nearly identical. Both groups’ conversion rates were comparable. There was no relevant
variation in intra- and postoperative consequences between the two groups. After 3 days, there was no discernible
dissimilarity within the both groups, but group I’s visual analog scale score was much lower than group II’s at 24 h. Both
groups’ hospital stays were comparable. With 3% within group I and 0% within group II, CBD stone retention does not
differ substantially between the two groups. The two groups’ levels of patient satisfaction did not very much, also there
were no mortalities.
Conclusion: One-stage LCBDE+LC and two-stage ERCP+LC are comparable with reference to the need for change to
other approaches, operative period, intra and postoperative problems, hospital stay, residual stones and mortality. Both
have worse outcomes with intra- and postoperative complications.