Abstract
Background. Choledocholithiasis represents a significant complication of gallstone disease, with common bile duct stones potentially leading to severe clinical consequences. This retrospective study aimed to compare the outcomes of endoscopic retrograde cholangiopancreatography versus open laparotomic surgery for the management of choledocholithiasis at a tertiary care center. Materials and methods. A total of 38 patients were included and divided into two groups: Group 1 (n = 21) underwent endoscopic retrograde cholangiopancreatography, while Group 2 (n = 17) received open laparotomy with biliary drainage. Liver function parameters, including serum bilirubin, thymol turbidity, alanine aminotransferase, and aspartate aminotransferase, were assessed before and after intervention. Results. In Group 1, serum bilirubin levels significantly decreased from 172.3 ± 2.21 μmol/L to 24.2 ± 0.97 μmol/L postoperatively (P < 0.001), accompanied by marked improvements in thymol turbidity, alanine aminotransferase, and aspartate aminotransferase (P < 0.05). In contrast, Group 2 exhibited moderate, non-significant biochemical changes. No complications were observed in Group 1, whereas one patient in Group 2 experienced partial failure of the biliary-enteric anastomosis. Additionally, hospital stay was significantly shorter in Group 1 compared to Group 2. Conclusion. These findings indicate that endoscopic retrograde cholangiopancreatography should be considered the first-line treatment for common bile duct stones when technically feasible, offering faster hepatic recovery, fewer complications, and shorter hospitalization. Open laparotomic surgery remains essential in cases of endoscopic retrograde cholangiopancreatography failure or in complex presentations.