Comparison of Open, Laparoscopic-endoscopic and One-stage Laparoscopic Approaches for Treatment of Gallbladder and Common Bile Duct Stones
Keywords:
Gallstones, Common Bile Duct Stones, Laparoscopic Surgery, ERCP, Open Cholecystectomy, Minimally Invasive Surgery, Biliary StonesAbstract
Background: Gallstones in the gallbladder often sit alongside stones lodged in the common bile duct (CBD), creating a challenging picture that usually calls for both removal of the gallbladder and clearing of the duct. Surgeons can choose from several pathways: the long-established open procedure, a two-step laparo-endoscopic approach done in separate sessions, or the newer single-stage laparoscopic method that aims to tackle everything at once. Across these options, the levels of invasiveness, speed of recovery, and strain on hospital resources can differ. To compare the clinical outcomes of open cholecystectomy with CBD exploration, laparo-endoscopic approach (laparoscopic cholecystectomy followed by ERCP), and one-stage laparoscopic management of gallbladder and CBD stones.
Methods: This comparative study involved a total of seventy-one patients who underwent treatment between January 2022 and January 2023. Participants were categorized into three groups according to the specific surgical approach employed. Key outcomes assessed were operative time, complication rates, time to oral intake and ambulation, length of hospital stay, stone clearance, readmission, and level of patient satisfaction. Data were analyzed with appropriate statistical techniques, and a value of p less than 0.05 was accepted as statistically significant.
Results: All three groups demonstrated high stone clearance rates, with no significant difference in major complication rates. The one-stage laparoscopic group had the highest satisfaction score and the shortest hospital stay. Operative time was longest in this group but was offset by faster recovery. The open surgery group had the most delayed postoperative course.
Conclusion: While open surgery remains a valid option, minimally invasive techniques, especially the one-stage laparoscopic approach, provide superior recovery and patient satisfaction. These results support the broader adoption of laparoscopic strategies in suitable candidates
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