title: [Laparoscopic versus endoscopic primary management of choledocholithiasis. A retrospective case-control study].
abstract: BACKGROUND
  The aim was to present the long-term results of one-stage laparoscopic procedure for the management of common bile duct (CBD) lithiasis in comparison with the primary endoscopic approach via ERCP.
  
  
  METHODS
  A retrospective case-control study was performed to determine the outcome of patients treated for CBD lithiasis (04/1997 - 11/2011). Data of patients with choledocholithiasis undergoing the two treatment modalities - laparoscopic common bile duct exploration plus laparoscopic cholecystectomy (LCBDE + LC, group A, n = 101) versus endoscopic retrograde cholangiopancreatography/sphincterotomy and laparoscopic cholecystectomy (ERCP/S + LC, group B, n = 116) were matched according to their clinical characteristics. Patients of group A underwent either laparoscopic choledochotomy or transcystic exploration. The policy was to convert to open choledochotomy only after the sequential application of the two treatment modalities (laparoscopic/endoscopic procedure) had failed.
  
  
  RESULTS
  No significant difference in morbidity was found between the groups (group A 8% versus group B 11.2%). Conversion to another procedure was mandatory in 12 out of 101 and 17 out of 116 patients of groups A and B, respectively. The mean follow-up period was 7.8 years (range 1-12 years).                 Effective laparoscopic treatment of CBD stones (cholecystectomy and CBD clearance) was possible in 89 of the 101 patients in group A (88.1%) compared with 99 of the 116 patients in group B (85.4%) after the endoscopic approach.
  
  
  CONCLUSIONS
  This study showes that both - primary endoscopy and one-stage laparoscopic management of CBD lithiasis - are highly effective and safe with comparable results.
authors.affiliation: 2nd Surgical Department and Surgical Oncology Unit of Korgialenio - Benakio, Red Cross Hospital Athens, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Sgourakis
authors.forename: S
authors.initials: S
authors.lastname: Lanitis
authors.forename: Ch
authors.initials: Ch
authors.lastname: Karaliotas
authors.forename: I
authors.initials: I
authors.lastname: Gockel
authors.forename: M
authors.initials: M
authors.lastname: Kaths
authors.forename: C
authors.initials: C
authors.lastname: Karaliotas
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D002758:Cholangiography / Q000401:mortality; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods* / Q000401:mortality; D017081:Cholecystectomy, Laparoscopic / Q000379:methods* / Q000401:mortality; D003131:Combined Modality Therapy; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods* / Q000401:mortality