Outcomes of endoscopic sphincterotomy vs open choledochotomy for common bile duct stones

doi:10.3748/wjg.v25.i4.485

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Jan 28, 2019 (publication date) through Jul 8, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jan 28, 2019; 25(4): 485-497
Published online Jan 28, 2019. doi: 10.3748/wjg.v25.i4.485

Table 2 Safety profile and procedure-related short-term outcomes of endoscopic sphincterotomy and open choledochotomy

Short-term outcome measure		Before matching			After matching
Short-term outcome measure		EST (n = 168)	OCT (n = 134)	P-value	EST (n = 88)	OCT (n = 88)	P-value
Time to biliary obstruction relief, mean ± SD, d		2.8 ± 1.6	7.6 ± 4.3	< 0.001^b	2.8 ± 1.6	7.1 ± 3.7	< 0.001^b
Anesthetic duration, median (IQR), min		174 (150-215)	222 (181.8-269.8)	< 0.001^b	175 (149-217.8)	207 (170-252.5)	< 0.001^b
¹Procedure time, median (IQR), min		105 (84-141.2)	150 (115.8-180)	< 0.001^b	110 (85-151.3)	145 (112-180)	< 0.001^b
No. of complete stone clearance sessions, n (%)				< 0.032^a			0.009^b
	1	149 (88.7)	128 (95.5)		77 (87.5)	86 (97.7)
	≥ 2	19 (11.3)	²6 (4.5)		11 (12.5)	²2 (2.3)
Methods of cholecystectomy, n (%)				< 0.001^b			< 0.001^b
	OC	7 (4.2)	117 (87.3)		1 (1.1)	79 (89.8)
	LC	143 (85.1)	0		75 (85.2)	0
³Hospital stay, median (IQR), d		6 (5-9)	9 (8-12)	< 0.001^b	6.5 (5-9.3)	9 (8-12)	< 0.001^b
Hospitalization cost, median (IQR), ×10³ yuan		17.9 (15.4-21.8)	17.6 (13.7-21.2)	0.083	18.0 (15.9-21.4)	17.8 (14.3-21.5)	0.115
Complications, n (%)		19 (11.3)	19 (14.2)	0.455	9 (10.2)	9 (10.2)	1.000
	Bleeding	3 (1.8)	7 (5.2)	0.097	1 (1.1)	4 (4.5)	0.173
	PEP	6 (3.6)	0	0.027^a	3 (3.4)	0	0.081
	Hyperamylasemia	8 (4.8)	0	0.010^a	4 (4.5)	0	0.043^a
	Cholangitis	2 (1.2)	1 (0.7)	0.699	1 (1.1)	1 (1.1)	1.000
	Bile leakage	0	5 (3.7)	0.012^a	0	2 (2.3)	0.155
	Port site infection	0	6 (4.8)	0.006^b	0	2 (2.3)	0.155

¹Procedure time in the open choledochotomy group was exclusively for common bile duct exploration.

²Retained stones were evacuated by endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation at a later date.

³Hospital stay for the EST group was defined as the duration of post-EST stay plus post-cholecystectomy stay.

^aP < 0.05.

^bP < 0.01.

EST: Endoscopic sphincterotomy; OCT: Open choledochotomy; OC: Open cholecystectomy; LC: Laparoscopic cholecystectomy; PEP: Post-endoscopic retrograde cholangio pancreatography pancreatitis; SD: standard deviation; IQR: Interquartile range.

Citation: Zhou XD, Chen QF, Zhang YY, Yu MJ, Zhong C, Liu ZJ, Li GH, Zhou XJ, Hong JB, Chen YX. Outcomes of endoscopic sphincterotomy vs open choledochotomy for common bile duct stones. World J Gastroenterol 2019; 25(4): 485-497
URL: https://www.wjgnet.com/1007-9327/full/v25/i4/485.htm
DOI: https://dx.doi.org/10.3748/wjg.v25.i4.485