Contrasting Analysis On The Treatment Of Common Bile Duct Stone Using Endoscopic Versus Surgical Procedure From Several Faces

Objective: To explore efficiency of endoscopic therapy on common bile duct stone compared with surgical operation from several faces.Methods: 122 patients with common bile duct stone were included from Feb 2002 to July 2007 in the second affiliated hospital of Dalian Medical University. All patients were divided into two groups according to either endoscopic therapy (E group) or surgical operation (S group). We analyzed retrospectively the rate of treatment, mortality, residual stone, recent complications, WBC count and temperature on 1 day and 3 day after treatment, postoperative fasting time, mean hospitalization period and fee and made a comparison between two groups.Results: 60 patients were performed by endoscopic treatment, 93.33% of which had complete removal of stones. 62 patients were performed by surgical operation, 95.16% of which had complete removal of stone. There was no difference between two groups (P>0.05). In addition, there was no difference in occurance of residual stone between two groups (0 vs 4.48%, P>0.05). 4 patients of E group were associated with complications, including acute pancreatitis (1 patient), hyperamylemia (3 patients). 16 patients of S group suffered from the following complications: pneumonia (4 patients), incisure infection (6 patients), infection aroud drainage tube (1 patients), urinary infection (1 patients), fistula (2 patients), DIC (1 patients), and MOF (1 patients). There was significant difference between two groups (6.67% vs 25.81%, P<0.05). Compared with S group, WBC count 1 and 3 day after operation were obviously lower (P<0.05, P<0.05 respectively). Mean hospitalization period and fee in E group were also fewer than those of S group (P<0.05, P<0.05 respectively).Conclusions: Endoscopic therapy has better efficiency than surgical operation on common bile duct stone, which takes on higher success rate, fewer complications and the mortality rate, no body anesthesia, shorter hospitalization period, and fewer fee. It can be the first choice of treatment on bile stones despite certain limitations and hazard.