Comparative study of endoscopic vs. open surgical management in 50 cases of choledocholithiasis

Introduction: Choledocholithiasis, or the presence of gallstones within the common bile duct (CBD), remains a significant clinical challenge, with management strategies ranging from endoscopic to open surgical procedures. The choice of modality depends on disease severity, patient profile, and available expertise. Our aim is to compare the outcomes of endoscopic and open surgical management in choledocholithiasis in terms of success rate, procedure duration, hospital stay, and postoperative complications. Material and Methods: This prospective clinical study included 50 patients with choledocholithiasis admitted to Civil Hospital, Ahmedabad, between March 2024 and March 2025. Patients were randomly divided into two groups: Group A (endoscopic management, n = 40) and Group B (open surgical management, n = 10). The parameters studied included success rate, procedure duration, hospital stay, and complication profile. Results: The success rate was 95% in the endoscopic group and 100% in the open surgical group. The median procedure time was 45 min (range 30-60) for endoscopic procedures and 140 min (range 100-180) for open surgery. The median hospital stay was significantly shorter in the endoscopic group (3 days, range 1-5) compared to the open surgical group (10 days, range 7-15). Complications were fewer in the endoscopic group (pancreatitis in 2 cases, cholangitis in 1 case) compared to the open group (surgical site infection (SSI) in 2 cases, bile leak in 1 case). Conclusion: Endoscopic management of choledocholithiasis offers shorter operative time, reduced hospital stay, and fewer complications compared to open surgical procedures, making it the preferred modality whenever feasible.