Common Bile Duct Stones Clinical Trial
Official title:
Prospective Randomized Trial of Laparoscopic Cholecystectomy Plus Laparoscopic Common Bile Duct Exploration (LC + LCBDE) Versus Endoscopic Retrograde Cholangiopancreatography Sphincterotomy Plus Laparoscopic Cholecystectomy (ERCP/S + LC) for Common Bile Duct Stone Disease
Objective: We compared outcome parameters for good-risk patients with classic signs,
symptoms, laboratory and abdominal imaging features of cholecystolithiasis and
choledocholithiasis randomized to either LC + LCBDE or ERCP/S + LC.
Design: Our study was a prospective trial conducted following written informed consent with
randomization by the serially-numbered opaque envelope technique.
Setting: Our institution is an academic teaching hospital and the central receiving and
trauma center for the City and County of San Francisco.
Patients: We randomized 122 patients (American Society of Anesthesiologists Grade I or II)
meeting entry criteria. Ten of these patients, excluded from outcome analysis, were protocol
violators having signed out of the hospital against medical advice before one of both
procedures were completed.
Interventions: Treatment was pre-operative endoscopic retrograde cholangiopancreatography
sphincterotomy (ERCP/S) followed by laparoscopic cholecystectomy (LC), or laparoscopic
cholecystectomy plus laparoscopic common bile duct exploration (LC + LCBDE).
Main Outcome Measures: The primary outcome measure was efficacy of stone clearance from the
common bile duct. Secondary endpoints were length of hospital stay, cost of index
hospitalization, professional fees, hospital charges, morbidity and mortality, and patient
acceptance and quality of life scores.
Objective: We compared outcome parameters for good-risk patients with classic signs,
symptoms, laboratory and abdominal imaging features of cholecystolithiasis and
choledocholithiasis randomized to either LC + LCBDE or ERCP/S + LC.
Design: Our study was a prospective trial conducted following written informed consent with
randomization by the serially-numbered opaque envelope technique.
Setting: Our institution is an academic teaching hospital and the central receiving and
trauma center for the City and County of San Francisco.
Patients: We randomized 122 patients (American Society of Anesthesiologists Grade I or II)
meeting entry criteria. Ten of these patients, excluded from outcome analysis, were protocol
violators having signed out of the hospital against medical advice before one of both
procedures were completed.
Interventions: Treatment was pre-operative endoscopic retrograde cholangiopancreatography
sphincterotomy (ERCP/S) followed by laparoscopic cholecystectomy (LC), or laparoscopic
cholecystectomy plus laparoscopic common bile duct exploration (LC + LCBDE).
Main Outcome Measures: The primary outcome measure was efficacy of stone clearance from the
common bile duct. Secondary endpoints were length of hospital stay, cost of index
hospitalization, professional fees, hospital charges, morbidity and mortality, and patient
acceptance and quality of life scores.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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