[Comparative analysis of different methods in the treatment of patients with acute calculous cholecystitis and choledocholithiasis]

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biliary Tract Disease

Background:

• Cholelithiasis (gallstones) is a common condition requiring surgical intervention.
• Acute calculous cholecystitis and choledocholithiasis present significant clinical challenges.
• Traditional open surgery for these conditions carries notable complication rates.

Purpose of the Study:

• To compare the efficacy and safety of conventional open surgery versus endoscopic techniques for acute calculous cholecystitis with choledocholithiasis.
• To evaluate treatment outcomes, including complications, residual stones, and hospital stay.

Main Methods:

• Retrospective analysis of 1988 operations for cholelithiasis.
• Comparison of 52 patients undergoing open choledocholithotomy (Group 1) versus 66 patients treated with endoscopic techniques (Group 2).
• Data collection on complications, residual choledocholithiasis, mortality, and length of hospital stay.

Main Results:

• Endoscopic treatment (Group 2) resulted in significantly fewer complications (2% vs 7.6%) and residual choledocholithiasis (2% vs 13.4%) compared to open surgery (Group 1).
• No mortality was observed in the endoscopic group, versus 5.7% in the open surgery group.
• Mean hospital stay was substantially shorter with endoscopic techniques (15.1 days vs 24.7 days).

Conclusions:

• Minimally invasive endoscopic technologies offer superior outcomes for treating acute calculous cholecystitis and choledocholithiasis.
• Endoscopic approaches reduce patient morbidity, mortality, and length of hospitalization.
• These findings support the adoption of minimally invasive techniques in managing these biliary conditions.