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Meta-Analysis
. 2025 Jun 1;35(3):e1364.
doi: 10.1097/SLE.0000000000001364.

Comparative Efficacy and Complications Between One-stage Transcystic Common Bile Duct Exploration and Two-stage ERCP Plus Laparoscopic Cholecystectomy for Treatment of Choledocholithiasis: A Systematic Review and Meta-analysis

Zachary Malaussena  1 , Brody Smith  1 , Ila Sethi  2 , Paige DeBlieux  3 , Rahul Mhaskar  1   4 , Joseph Sujka  1   5 , Christopher DuCoin  1   5 , Salvatore Docimo Jr  1   5
Affiliations
Meta-Analysis

Comparative Efficacy and Complications Between One-stage Transcystic Common Bile Duct Exploration and Two-stage ERCP Plus Laparoscopic Cholecystectomy for Treatment of Choledocholithiasis: A Systematic Review and Meta-analysis

Zachary Malaussena et al. Surg Laparosc Endosc Percutan Tech. .

Abstract

Background: Early and effective management of choledocholithiasis is imperative to decrease patient morbidity. Despite the widespread use of ERCP, advancements in laparoscopy and choledochoscopy have renewed interest in laparoscopic CBD exploration (LCBDE). This meta-analysis compares outcomes of 2-stage ERCP followed by laparoscopic cholecystectomy (LC) versus one-stage transcystic LCBDE plus LC.

Methods: A comprehensive literature search was performed in PubMed, CENTRAL, and Embase databases according to PRISMA guidelines. Studies were selected based on specific criteria. Data on stone clearance, postoperative pancreatitis, bleeding, mortality, and length of stay were extracted.

Results: Seven comparative non-randomized studies enrolling 669 "one-stage LCBDE patients" and 724 "two-stage ERCP patients" were included. Overall, there were no statistically significant differences regarding the rates of stone clearance, pancreatitis, bleeding, and mortality between the 2 groups.

Conclusion: One-stage transcystic LCBDE is noninferior to the 2-stage ERCP + LC approach, supporting its use as a first-line treatment for choledocholithiasis.

Keywords: ERCP; LCBDE; choledocholithiasis; transcystic choledochoscopy.

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Conflict of interest statement

S.D., Jr. is a consultant for BD, Boston Scientific, Medtronic, and Intuitive. C.D.C. is a consultant for Johnson & Johnson, Medtronic, and Intuitive Surgical. J.S. is a consultant for Intuitive Surgical and Enterra Medical. R.M. serves as a chair on a data safety monitoring board at Tampa General Hospital in vascular surgery. The remaining authors declare no conflicts of interest.

References

    1. Tazuma S. Gallstone disease: Epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Pract Res Clin Gastroenterol. 2006;20:1075–1083.
    1. Yao CC, Huang SM, Lin CC, et al. Assessment of common bile duct using laparoscopic ultrasound during laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2009;19:317–320.
    1. Dasari BV, Tan CJ, Gurusamy KS, et al. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev. 2013;2013:Cd003327.
    1. Hajibandeh S, Hajibandeh S, Sarma DR, et al. Laparoscopic transcystic versus transductal common bile duct exploration: a systematic review and meta-analysis. World J Surg. 2019;43:1935–1948.
    1. Acho R, Calzon M, Docimo S Jr. How I Do It: Robotic Choledochoscopy. Surg Laparosc Endosc Percutan Tech. 2024;34:233–236.

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