Outcomes of endoscopic sphincterotomy vs open choledochotomy for common bile duct stones

Table 2 Safety profile and procedure-related short-term outcomes of endoscopic sphincterotomy and open choledochotomy

Short-term outcome measure		Before matching			After matching
		EST (n = 168)	OCT (n = 134)	P-value	EST (n = 88)	OCT (n = 88)	P-value
Time to biliary obstruction relief, mean ± SD, d		2.8 ± 1.6	7.6 ± 4.3	< 0.001b	2.8 ± 1.6	7.1 ± 3.7	< 0.001b
Anesthetic duration, median (IQR), min		174 (150-215)	222 (181.8-269.8)	< 0.001b	175 (149-217.8)	207 (170-252.5)	< 0.001b
1Procedure time, median (IQR), min		105 (84-141.2)	150 (115.8-180)	< 0.001b	110 (85-151.3)	145 (112-180)	< 0.001b
No. of complete stone clearance sessions, n (%)				< 0.032a			0.009b
	1	149 (88.7)	128 (95.5)		77 (87.5)	86 (97.7)
	≥ 2	19 (11.3)	26 (4.5)		11 (12.5)	22 (2.3)
Methods of cholecystectomy, n (%)				< 0.001b			< 0.001b
	OC	7 (4.2)	117 (87.3)		1 (1.1)	79 (89.8)
	LC	143 (85.1)	0		75 (85.2)	0
3Hospital stay, median (IQR), d		6 (5-9)	9 (8-12)	< 0.001b	6.5 (5-9.3)	9 (8-12)	< 0.001b
Hospitalization cost, median (IQR), ×103 yuan		17.9 (15.4-21.8)	17.6 (13.7-21.2)	0.083	18.0 (15.9-21.4)	17.8 (14.3-21.5)	0.115
Complications, n (%)		19 (11.3)	19 (14.2)	0.455	9 (10.2)	9 (10.2)	1.000
	Bleeding	3 (1.8)	7 (5.2)	0.097	1 (1.1)	4 (4.5)	0.173
	PEP	6 (3.6)	0	0.027a	3 (3.4)	0	0.081
	Hyperamylasemia	8 (4.8)	0	0.010a	4 (4.5)	0	0.043a
	Cholangitis	2 (1.2)	1 (0.7)	0.699	1 (1.1)	1 (1.1)	1.000
	Bile leakage	0	5 (3.7)	0.012a	0	2 (2.3)	0.155
	Port site infection	0	6 (4.8)	0.006b	0	2 (2.3)	0.155

¹Procedure time in the open choledochotomy group was exclusively for common bile duct exploration.

²Retained stones were evacuated by endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation at a later date.

³Hospital stay for the EST group was defined as the duration of post-EST stay plus post-cholecystectomy stay.

^aP < 0.05.

^bP < 0.01.

EST: Endoscopic sphincterotomy; OCT: Open choledochotomy; OC: Open cholecystectomy; LC: Laparoscopic cholecystectomy; PEP: Post-endoscopic retrograde cholangio pancreatography pancreatitis; SD: standard deviation; IQR: Interquartile range.