A CONTEMPORARY APPROACH TO CHOLEDOCHOLITHIASIS
ATİLA KORKMAZ, E OKAN HAMAMCI, BÜLENT ÖZCAN, HASAN BESİM, NİLÜFER ERVERDİ
Ankara Numune Hastanesi, 6.Cerrahi Kliniği, ANKARA
ERCP can be used as a therapeutic technigue in choledocholithiasis and when combined with laparosopic cholecystectomy (LC) a relatively minimally invasive surgical technigue emerges. Between 1994 and 1996, 64 patients underwent preoperative ERCP because of the suspicion of choledocholithiasis. İndications for ERCP were clinical jaundice, biochemical and/or ultrasonographic abnormalities. None of the parameters evaluated in this study cannot be shown to specific or sensitive in the diagnosis of choledocholithiasis. In 13 patients, open surgery was performed because of the complications or failure in ERCP. 51 patients underwent laparoscopic interventions however 7 were converted to open surgery because of technical/anatomical problems. 44 cases were completed laparoscopically. Median hospital stay for ERCP was 4 (1-22) days and median stay after LC was 1(1-6) day. Two wound infection (%4), one gallbladder perforation (%2) and one CBD laceration (%2) was seen after LC and one patient died because of DIC during postoperative period. No mortality was seen associated with ERCP and one duodenal rupture and one pancreatitis occured which was treated by open surgery. In conclusion, ERCP + LC is a modality that can be used in patients when choledocholithiasis is suspected.
Keywords: ERCP, CHOLEDOCHOLITHIASIS, LAPAROSKOPIC CHOLECYSTECTOMY