title: [Efficiency of laparoscopic vs endoscopic management in cholelithiasis and choledocholithiasis. Is there any difference?]
abstract: BACKGROUND
  Concomitant cholelithiasis and choledocholithiasis is a disease where incidence increases with age and can have serious complications such as pancreatitis, cholangitis and liver abscesses, but its management is controversial, because there are minimally invasive laparoscopic and endoscopic surgical procedures.
  
  
  OBJECTIVE
  To compare the efficiency in the management of cholelithiasis and choledocholithiasis with laparoscopic cholecystectomy with common bile duct exploration vs cholangiopancreatography endoscopic retrograde+laparoscopic cholecystectomy.
  
  
  METHODS
  Retrospective analysis of a five year observational, cross sectional multicenter study of patients with cholelithiasis and concomitant high risk of choledocholithiasis who were divided into two groups and the efficiency of both procedures was compared. Group 1 underwent laparoscopic cholecystectomy with common bile duct exploration and group 2 underwent cholangiopancreatography endoscopic retrograde+laparoscopic cholecystectomy.
  
  
  RESULTS
  40 patients, 20 were included in each group, we found p=0.10 in terms of operating time; when we compared hospital days we found p=0.63; the success of stone extraction by study group we obtained was p=0.15; the complications presented by group was p=0.1 and the number of hospitalizations by group was p ≤ 0.05 demonstrating statistical significance.
  
  
  CONCLUSIONS
  Both approaches have the same efficiency in the management of cholelithiasis and choledocholithiasis in terms of operating time, success in extracting stone, days of hospitalization, postoperative complications and conversion to open surgery. However the laparoscopic approach is favourable because it reduces the number of surgical anaesthetic events and the number of hospital admissions.
authors.affiliation: Servicio de Cirugía General, Hospital Central Norte PEMEX, Ciudad de México, México. Electronic address: angelesherreracirugia@gmail.com.
authors.forename: María de Los Angeles
authors.initials: MLA
authors.lastname: Herrera-Ramírez
authors.affiliation: Servicio de Endoscopia Gastrointestinal, Hospital Central Sur PEMEX, Ciudad de México, México.
authors.forename: Hugo
authors.initials: H
authors.lastname: López-Acevedo
authors.affiliation: Servicio de Cirugía General, Hospital Central Norte PEMEX, Ciudad de México, México.
authors.forename: Gustavo Adolfo
authors.initials: GA
authors.lastname: Gómez-Peña
authors.affiliation: Servicio de Cirugía General, Hospital Central Norte PEMEX, Ciudad de México, México.
authors.forename: Carlos Javier
authors.initials: CJ
authors.lastname: Mata-Quintero
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D042883:Choledocholithiasis / Q000601:surgery*; D002769:Cholelithiasis / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cholangiopancreatography endoscopic retrograde; Choledocholithiasis; Cholelithiasis; Cirugía; Colangiopancreatografía retrógrada endoscópica; Colecistectomía laparoscópica; Coledocolitiasis; Colelitiasis; Exploración de vía biliar laparoscópica; Laparoscopic cholecystectomy; Laparoscopic common bile duct exploration; Surgery