Abstract: Background: This study details Assiut and South Valley universities experience in treating combined gall bladder
and common bile duct stones in a single session, either with Endoscopic Retrograde Cholangio-Pancreatography (ERCP) for
Common Bile Duct (CBD) stone extraction followed by laparoscopic cholecystectomy (LC), or totally laparoscopic treatment.
Patients and methods: In this prospective randomized study, 46 consecutive patients with confirmed cholecystocholedocholithiasis
were randomized to 2 groups. Group (A) included 24 patients treated with single-session ERCP for CBD
stone extraction and laparoscopic cholecystectomy [ERCP-LC]. Group (B) included 22 patients treated with laparoscopic CBD
exploration and laparoscopic cholecystectomy [LCBDE-LC]. Demographic data, operative time, CBD clearance success rate,
short term complications and duration of hospital stay were recorded. Results: Patients included 28 females and 18 males with
mean age of 42.1 ± 12.1 years (range 17 – 71 years). In 22/24 patients (91.7%) ERCP-LC was done successfully. Mean
operative time was 105 ± 19.1 minutes (50-150 min.). No intra-operative complications occurred. Early post-operative
complications occurred in 3 patients (12.5%). Mean hospital stay was 2.1 ± 0. 91 days (1-6 days). In the other group, LCBDELC
was performed successfully in 22/22 patients (100%). Mean operative time was 145 ± 23 minutes (100-180 min.). Minor
intra-operative complications (bleeding) occurred in 2/22 cases (9%). Minor early post-operative complications (bile leak,
ileus, bleeding) occurred in 4/22 patients (18%). Mean hospital stay was 2.8 ± 0.83 days (2-7 days). Conclusion: Single session
ERCP-LC and LCBDE-LC procedures for management of cholecysto-choledocholithiasis are feasible, safe, and effective and
have comparable outcome regarding success rate, peri-operative complications. ERCP-LC has statistically significant less
operative time and less hospital stay.