Simultaneous laparoscopic cholecystectomy and percutaneous papillary balloon dilatation for cholecystocholedocholithiasis.

Aim: We evaluated the effectiveness of simultaneous laparoscopic cholecystectomy (LC) and percutaneous papillary balloon dilatation (PPBD) under general anesthesia in the treatment of cholecystocholedocholithiasis in elderly patients in poor general condition.

Patients And Methods: We treated 17 patients (group 1) with LC and PPBD as separate procedures and 21 patients (group 2) with simultaneous LC and PPBD under general anesthesia. We compared the success rates, complications, durations of percutaneous transhepatic biliary drainage (PTBD) and hospital stays of the 2 groups.

Results: The stones were successfully pushed out into the duodenum in all patients in both groups. All patients in group 1 complained of transient pain caused by balloon dilatation of the papilla. In group 2, PPBD was performed comfortably in all patients because of the general anesthesia. The mean postoperative stay of patients in both groups was 9 days. The overall duration of the hospital stay and the duration of PTBD were 28 +/- 5 and 25 +/- 9 days, respectively, in group 1, and 18 +/- 7 and 15 +/- 8 days in group 2 (significant difference: p < 0.01 and p < 0.01, respectively). There were no deaths or major complications, although transient hyperamylasemia occurred in both groups.

Conclusions: Cholecystocholedocholithiasis can be treated by simultaneous LC and PPBD under general anesthesia without laparotomy, sphincterotomy, choledochotomy or the discomfort arising from papillary dilatation.