Comparing Laparoscopic and Open Choledochoduodenostomy At a Single Institution

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Minimally Invasive Surgical Techniques
• Biliary Tract Interventions

Background:

• Choledochoduodenostomy (CDD) is an alternative for difficult choledocholithiasis cases.
• Laparoscopic CDD is being evaluated against traditional open CDD.
• This study compares outcomes of laparoscopic versus open CDD.

Purpose of the Study:

• To evaluate the feasibility and outcomes of laparoscopic CDD.
• To compare laparoscopic CDD with open CDD in terms of surgical results and complications.
• To assess long-term outcomes of both surgical approaches.

Main Methods:

• Retrospective analysis of 65 patients undergoing CDD (2011-2021) for difficult endoscopic clearance.
• Comparison of 20 laparoscopic CDD cases (post-April 2016) with 45 open CDD cases (pre-April 2016).
• Evaluation of operative time, blood loss, hospital stay, bile leakage, reflux cholangitis, and anastomosis stenosis.

Main Results:

• Laparoscopic CDD had longer operative times (187 vs 125 min) and higher minor bile leakage (10% vs 2.2%).
• Laparoscopic CDD showed shorter hospital stays (8 vs 14 days) and less blood loss (32 vs 95 mL).
• No significant difference was found in reflux cholangitis or anastomosis stenosis between groups.

Conclusions:

• Laparoscopic CDD is a feasible and safe procedure.
• Laparoscopic CDD is not inferior to open CDD for selected patients.
• The minimally invasive nature of laparoscopic CDD offers potential advantages.