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Mohamed abdelaziz hussein

Alexandria university school of medicne , Egypt

Title: Role of Endoscopic retrograde cholangiopancreatography(ERCP) versus percutaneous transhepatic approach(PTC) for management of distal common bile duct (CBD)strictures: Randomized Clinical Trial

Biography

Biography: Mohamed abdelaziz hussein

Abstract

Distal common bile duct strictures (CBD)are caused by heterogenous group of conditions which can be benign or malignant that  can be managed by different methods .the aim of this study is to compare the role of ERCP versus percutaneous transhepatic approach in the management of distal CBD strictures

Methods: The study was conducted on 40subjects (20 patients with distal CBD strictures with endoscopic management(group I  )and 20 patients with distal CBD strictures with transhepatic management(groupII ).distal CBD strictures will be evaluated by history ,clinical examination,laboratory investiagations ,radiological investigations including (ultrasonography ,multislice CT , MRCP).evaluated outcomes included technical success rate and therapeutic success rate ,major complications rate ,30 –day mortality rates and mean hospital stay.

Results: in our study it was found that 25% of group I was technically unsuccessful while 75% was successful. on the other hand 30% of group II was unsuccessful while 70% was successful it was  also  found that 75% of group I was therapeutically successful while 25% of group I was therapeutically unsuccessful ,on the other hand it was found that 70% of group II was therapeutically successful while 30 % of group II was therapeutically unsuccessful.considering the rate of complications it was found that 30% of group I had developed major complications while 30% of group II had developed major complaications  As regard 30 day mortality It was found that mortality was higher in patients of group II (60%) as compared to group I (40%) however the relation was not statistically significant.The relation between the two groups showed statistical significance as regard mean hospital stay (p=0.0327) , it was showed that the mean hospital stay in group I was (7.35+_5.8) as compared to the mean hospital stay in group II which was (13.5+_10.8)

Conclusions: Distal CBD strictures are better managed by ERCP although they are technically complementary to each other  as compared to transhepatic approach as it provides more diagnostic benefits, less mortality and significant less hospital stay