Comparison of Outcomes between Endoscopic Retrograde Cholangiopancreatography and Open Surgical Management for Common Bile Duct Stones

Abstract

Objectives: Our objective was to identify stone clearance rates and complications related to procedures, particularly post-procedural pancreatitis, in patients with common bile duct (CBD) stones who underwent Endoscopic Retrograde Cholangiopancreatography (ERCP) versus open surgical exploration.
Methods: This comparative study included patients diagnosed with CBD stones who underwent either ERCP or open surgical exploration. The demographic details, rates of stone clearance, complications associated with the procedure, duration of hospitalization, and occurrence of pancreatitis following the procedure were documented and analyzed for comparison between the two treatment groups.
Results: In this study, we included a total of 144 patients; 72 patients underwent ERCP, and 72 underwent open surgical treatment. We found that the ERCP group had higher stone clearance rates compared to the open surgical group. We did not observe procedure-related complications, e.g. post-procedural pancreatitis (12.5 % following ERCP compared with 4.2 % in the surgical group), and even shorter hospital stay duration in the ERCP group compared to the open surgical group. Hypertension and hyperglycemia were among the other complications, with no marked differences noted between the groups.
Conclusion: We concluded that both treatment options are reliable for the management or treatment of CBD stones. ERCP is comparatively better due to its minimally invasive nature and reduced hospital stay duration, though it carries a slight risk of pancreatitis following the procedure. Selecting suitable patients is key to maximizing stone removal success and minimizing complications..