A COMPARATIVE STUDY ON LAPAROSCOPIC COMMON BILE DUCT EXPLORATION VERSUS ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN THE MANAGEMENT OF CHOLEDOCHOLITHIASIS

Abstract

Introduction: Choledocholithiasis occurs in 8-20% of patients with symptomatic gallstones, with increased incidence in older adults and those with recurrent biliary symptoms. The clinical presentation of choledocholithiasis ranges from asymptomatic cases, often detected incidentally on imaging, to severe manifestations, including acute cholangitis and gallstone pancreatitis, which require urgent intervention. Treatment modalities include Laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde cholangio-pancreatography (ERCP) Materials & methods: This is a Comparative Cross-sectional study conducted in Department of Surgery, in Thoothukudi. Study was done for a period of 18 months including 12 months for patient recruitment and treatment, and 6 months for follow-up. This includes 60 patients, with 30 patients in each group (LCBDE+LC and ERCP+LC) Results: The mean age of study participants was 44 years. Females were predominantly affected than males. Jaundice prevalence: 23.3% in ERCP and 20% in LCBDE.  Mean procedure time and Overall complication rate were 180 minutes, 26.7% for ERCP and 170 minutes, 16.7% for LCBDE respectively. Conclusion: Both ERCP and LCBDE were shown to be effective and safe in treating choledocholithiasis, with comparable procedure duration and complication profiles. The choice between ERCP and LCBDE may depend on institutional expertise, patient-specific factors, and resource availability