COMPARISON OF CLINICAL EFFICACY AND SAFETY OF LCBDE VERSUS ERCP IN THE TREATMENT OF BILE DUCT STONES AND ANALYSIS OF RELATED FACTORS INFLUENCING POST-OPERATIVE ACUTE PANCREATITIS

Main Article Content

Rida Waheed Bhatti
Muhammad Hamza Asif
Mohammad A M A Mohammad
Tayyaba Ghulam
Reem Mohammad
Turki Aldhemeer

Keywords

Acute pancreatitis, Bile duct stones, Cholangiopancreatography, Common Bile Duct, Intraoperative Complications, Tertiary Care, Treatment Comparison

Abstract

 Background: Bile duct stones present a clinical challenge, and LCBDE (Endoscopic Retrograde Cholangiopancreatography) and ERCP (Laparoscopic Common Bile Duct Exploration) are two of the most prominent interventions.
Objectives: To compare the clinical efficacy and safety of these procedures, as well as to identify factors that influence post-operative acute pancreatitis.
Methods: This cross-sectional analysis was conducted at a tertiary care hospital in Lahore Pakistan between March 2022 and June 2023, enrolling 44 patients undergoing LCBDE and 92 patients undergoing ERCP. Inclusion criteria comprised patients aged 18-70 years with ultrasonographic evidence of cholecystolithiasis, among other parameters. A structured questionnaire was used to collect information extending from demographics to post-operative outcomes.
Results: The demographic characteristics of the two groups, including age, gender, and BMI, did not differ significantly. 70.45% of LCBDE patients had gallstones concurrently, compared to 53.26 % of ERCP patients (p>0.05). The number and magnitude of bile duct stones, as well as the duration of procedures, were comparable between groups. There were intraoperative complications in 13.6 of LCBDE patients and 19.0% of ERCP patients. Postoperatively, 11.4 of LCBDE patients and 14.4% of ERCP patients developed acute pancreatitis (p>0.05). Other complications and the need for secondary interventions were statistically comparable (p>0.05).
Conclusion: Both LCBDE and ERCP are efficacious and safe treatments for bile duct stones in a tertiary care setting. The outcomes of both procedures were comparable in terms of complications and clinical efficacy. Additional large-scale, randomized studies could support these findings.

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