Prospective Randomized Trial Comparing Endoscopic Sphincterotomy Followed by Surgery with Surgery Alone in Good Risk Patients with Choledocholithiasis. Issue 3 (1996)

• Record Type: Journal Article
• Authors: Kapoor, R.; Kaushik, S. P.; Saraswat, V. A.; Choudhuri, G.; Sikora, S. S.; Saxena, R.; Kapoor, V. K.
• Is Part Of: HPB surgery. Volume 9:Issue 3(1996)
• Page Start: 145
• Page End: 148
• Publication Date: 1996
• Subjects: Biliary tract -- Surgery -- Periodicals; Liver -- Surgery -- Periodicals; Pancreas -- Surgery -- Periodicals; 617.55
• DOI: 10.1155/1996/64373
• Languages: English
• ISSNs: 0894-8569

Abstract

Abstract : Background: Role of endoscopic sphincterotomy (ES) in high risk patients with choledocholithiasis is established but its role in good risk patients is unclear. Design: A prospective randomized trial of endoscopic sphincterotomy followed by surgery (ES + S) versus surgery alone (SA) in good risk patients with choledocholithiasis. Setting: A tertiary level referral hospital in north India; July 1991 to October 1993. Patients and methods : Thirty three out of 60 patients with choledocholithiasis were found suitable for randomization-16 were randomised to ES+S group and 17 to SA group. Results: Common bile duct clearance was achieved in 11/13 (85%) patients in ES+S group and in 13/15 (87%) in SA group. Major complications occurred in 4/13 (31%) patients in ES+S group and 3/16 (19%) patients in SA group. These differences were not statistically significant, but patients in ES+S group were exposed to morbidity twice, procedure related morbidity of ES being 23%. No significant differences were observed in hospital stay and cost of treatment. Conclusions: Results of this trial do not support use of precholecystectomy ES in good risk patients with choledocholithiasis, since it did not offer any advantage over surgery alone.