title: Comparison of long-term results of laparoscopic and endoscopic exploration of common bile duct.
abstract: BACKGROUND
  To compare long term results of laparoscopic and endoscopic exploration of common bile duct, to assess post-procedure quality of life.
  
  
  METHODS
  From September 1992 to August 2003, we performed 4058 cholecystectomies, out of which 479 (11.80%) patients had choledocholithiasis. There were 163 males and 316 females. Mean age was 63.65 ± 5.5 years. These patients were put in two groups. In the first group of 240 patients, a majority of patients underwent two-stage procedures. ERCP/ES was performed in 210 (87.50%) cases. In the second group of 239 patients, a majority of patients underwent single-stage procedures. ERCP/ES was done in 32 (13.38%) cases.
  
  
  RESULTS
  Mortality was zero in both groups. Morbidity was 15.1% in first group and 7.5% in second group. Mean hospital stay was 11.7 ± 3.2 days in first group and 6.2 ± 2.1 days in second group. Average operative time was 95.6 ± 20 minutes in first group and 128.4 ± 32 minutes in second group. Completed questionnaires received from 400 (83.50%) patients revealed better long-term results in the second group. Clinical features of low-grade cholangitis were seen in 20% of patients who underwent ES. Hence the post-procedure quality of life in patients who underwent single-stage procedures was definitely much better, because of minimal damage of sphincter of Oddi.
  
  
  CONCLUSIONS
  Single-stage laparoscopic operations provide better results and shorter hospital stay. Damage to sphincter of Oddi should be minimal, to avoid long-term low-grade cholangitis. In young patients, the operation of choice should be single-stage laparoscopic procedure with absolutely no damage to sphincter of Oddi.
authors.affiliation: Department of Surgical Diseases and Post-Graduate Education, Odessa State Medical University, Odessa Regional Hospital, Street Zabalotnaya 26, Katovskawa, Odessa 65025, Ukraine - CIS.
authors.forename: S S
authors.initials: SS
authors.lastname: Rai
authors.forename: V V
authors.initials: VV
authors.lastname: Grubnik
authors.forename: O L
authors.initials: OL
authors.lastname: Kovalchuk
authors.forename: O V
authors.initials: OV
authors.lastname: Grubnik