Analysis of the effectiveness of combined treatment approaches for patients with cholecystocholedocholithiasis

Authors

  • Bekhbudjon Rafikov Nikiforov’s All-Russian Center for Emergency and Radiation Medicine, 4/2, ul. Akademika Lebedeva, St. Petersburg, 194044, Russian Federation https://orcid.org/0009-0008-2892-7218
  • Pulat Askarov Samarkand State Medical University, 18, ul. Amira Temura, Samarkand, 100400, Republic of Uzbekistan
  • Dmitry Dvoryankin Nikiforov’s All-Russian Center for Emergency and Radiation Medicine, 4/2, ul. Akademika Lebedeva, St. Petersburg, 194044, Russian Federation https://orcid.org/0009-0007-0819-9498
  • Alexander Kochetkov Nikiforov’s All-Russian Center for Emergency and Radiation Medicine, 4/2, ul. Akademika Lebedeva, St. Petersburg, 194044, Russian Federation https://orcid.org/0000-0002-5636-6787
  • Victor Machs Nikiforov’s All-Russian Center for Emergency and Radiation Medicine, 4/2, ul. Akademika Lebedeva, St. Petersburg, 194044, Russian Federation

DOI:

https://doi.org/10.21638/spbu11.2024.404

Abstract

Most common one-stage surgical methods for the treatment of cholecystocholedocholithiasis include laparoscopic cholecystectomy with endoscopic retrograde cholangiopancreatography, endoscopic papillosphincterotomy and lithoextraction or with laparoscopic common bile duct exploration. From September 2013 to October 2023, at our center, 481 patients were treated for cholecystocholedocholithiasis and its complications, of which 114 patients received one-stage
combined treatment. The primary group consisted of 26 patients who had laparoscopic chole-cystectomy combined with laparoscopic common bile duct exploration, while 88 patients underwent laparoscopic cholecystectomy with endoscopic retrograde cholangiopancreatography,
endoscopic sphincterotomy and lithoextraction, with 57 of these forming the control group. The follow-up period extended up to five years, including telephonic consultations. The groups were analyzed for stone extraction effectiveness, duration of surgery, postoperative hospital stay, total hospital stay, and rates of somatic and surgical complications. Patients receiving laparoscopic cholecystectomy paired with laparoscopic choledocholithotomy experienced a significantly shorter hospital stay (p = 0,044), with no notable differences in postoperative complications observed. Both combined surgical approaches proved to be effective and safe in treating cholecystocholedocholithiasis.

Keywords:

cholecystocholedocholithiasis, laparoscopic cholecystectomy, laparoscopic choledocholithotomy, endoscopic papilosphincterotomy, endoscopic retrograde cholangiopancreatography, laparoscopic common bile duct exploration, combined surgery

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References

Литература

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References

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Sun W., Li J., Fang J., Duan Q., He A., Li, C. Comparison of Efficacy of ERCP+LC and LC+LCBDE on Cholecysto-Choledocholithiasis and Analysis of Risk Factors for Recurrence of Choledocholithiasis.Alternative therapies in health and medicine, 2024, vol. 30, no. 7, pp. 103–107.

Vakayil V., Klinker S. T., Sulciner M. L., Mallick R., Trikudanatha, G., Amateau S. K., Davido H. T., Freeman M., Harmon J. V. Single-stage management of choledocholithiasis: Intraoperative ERCP versus laparoscopic common bile duct exploration. Surgical endoscopy, 2020, vol. 34, no. 10, pp. 4616–4625. https://doi.org/10.1007/s00464-019-07215-w

Liao Y., Cai Q., Zhang X., Li F. Single-stage intraoperative ERCP combined with laparoscopic cholecystectomy versus preoperative ERCP Followed by laparoscopic cholecystectomy in the management of cholecystocholedocholithiasis: A meta-analysis of randomized trials. Medicine, 2022, vol. 101, no. 10. e29002. https://doi.org/10.1097/MD.0000000000029002

Platt T. E., Smith K., Sinha S., Nixon M., Srinivas G., Johnson N., Andrews S. Laparoscopic common bile duct exploration; a preferential pathway for elderly patients. Annals of medicine and surgery, 2012, vol. 30, pp. 13–17. https://doi.org/10.1016/j.amsu.2018.03.044

Yan Y., Sha Y., Yuan W., Yuan H., Zhu X., Wang B. One-stage versus two-stage management for acutecholecystitis associated with common bile duct stones: A retrospective cohort study. Surgical endoscopy,2022, vol. 36, no. 3, pp. 920–929. https://doi.org/10.1007/s00464-021-08349-6

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Published

2025-04-21

How to Cite

Rafikov, B., Askarov, P., Dvoryankin, D., Kochetkov, A., & Machs, V. (2025). Analysis of the effectiveness of combined treatment approaches for patients with cholecystocholedocholithiasis. Vestnik of Saint Petersburg University. Medicine, 19(4), 337–343. https://doi.org/10.21638/spbu11.2024.404

Issue

Vol. 19 No. 4 (2024)

Section

Surgery

License

Articles of "Vestnik of Saint Petersburg University. Medicine" are open access distributed under the terms of the License Agreement with Saint Petersburg State University, which permits to the authors unrestricted distribution and self-archiving free of charge.