ArticleJournal of the American College of Surgeons2011
Cost-effective treatment of patients with symptomatic cholelithiasis and possible common bile duct stones.
Article in Journal of the American College of Surgeons, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Meta-analysis of one- vs. two-stage laparoscopic/endoscopic management of common bile duct stones.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2012Pooled it
- Anisodamine accelerates spontaneous passage of single symptomatic bile duct stones ≤ 10 mm.World journal of gastroenterology · 2013Trial
- Upfront laparoscopic cholecystectomy versus preoperative MRCP or ERCP in patients with suspected choledocholithiasis.Surgical endoscopy · 2026Article
- National trends in utilization and readmission following intraoperative cholangiography in gallstone pancreatitis.Surgery open science · 2025Article
- The Safety and Cost Analysis of Outpatient Laparoendoscopy in the Treatment of Cholecystocholedocholithiasis: A Retrospective Study.Journal of clinical medicine · 2024Article
- Single-stage management of choledocholithiasis: intraoperative ERCP versus laparoscopic common bile duct exploration.Surgical endoscopy · 2020Article
- Telepresence-teleguidance to facilitate training and quality assurance in ERCP: a health economic modeling approach.Endoscopy international open · 2020Article
- Clinical significance and characteristics of left-sided gallbladder: case series study of 10 patients.Annals of surgical treatment and research · 2019Article
- Laparoscopic Ultrasonography Versus Magnetic Resonance Cholangiopancreatography in Laparoscopic Surgery for Symptomatic Cholelithiasis and Suspected Common Bile Duct Stones.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
- The Safety and Efficacy of Single-Operator Cholangioscopy in the Treatment of Difficult Common Bile Duct Stones after Failed Conventional ERCP.Journal of the Canadian Association of Gastroenterology · 2018Article
- Single-stage procedure for the treatment of cholecysto-choledocolithiasis: a surgical procedures review.Therapeutics and clinical risk management · 2018Review
- Routine surveillance cholangiography after percutaneous cholecystostomy delays drain removal and cholecystectomy.The journal of trauma and acute care surgery · 2017Article
- Prevalence and characteristics of clinically significant retained common bile duct stones after laparoscopic cholecystectomy for symptomatic cholelithiasis.Annals of surgical treatment and research · 2016Article
- Scoring System for the Management of Acute Gallstone Pancreatitis: Cost Analysis of a Prospective Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2016Article
- Management of Suspected Choledocholithiasis: A Decision Analysis for Choosing the Optimal Imaging Modality.Digestive diseases and sciences · 2016Article
- Is preoperative MRCP necessary for patients with gallstones? An analysis of the factors related to missed diagnosis of choledocholithiasis by preoperative ultrasound.BMC gastroenterology · 2015Article
- A novel therapeutic effect of statins on nephrogenic diabetes insipidus.Journal of cellular and molecular medicine · 2015Review
- MRCP is not a cost-effective strategy in the management of silent common bile duct stones.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2013Article
- Cost-effectiveness analysis of cholecystectomy during Roux-en-Y gastric bypass for morbid obesity.Surgery · 2012Article
- Variation in the use of intraoperative cholangiography during cholecystectomy.Journal of the American College of Surgeons · 2012Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundClinicians must choose a treatment strategy for patients with symptomatic cholelithiasis without knowing whether common bile duct (CBD) stones are present. The purpose of this study was to determine the most cost-effective treatment strategy for patients with symptomatic cholelithiasis and possible CBD stones. STUDY
designOur decision model included 5 treatment strategies: laparoscopic cholecystectomy (LC) alone followed by expectant management; preoperative endoscopic retrograde cholangiopancreatography (ERCP) followed by LC; LC with intraoperative cholangiography (IOC) ± common bile duct exploration (CBDE); LC followed by postoperative ERCP; and LC with IOC ± postoperative ERCP. The rates of successful completion of diagnostic testing and therapeutic intervention, test characteristics (sensitivity and specificity), morbidity, and mortality for all procedures are from current literature. Hospitalization costs and lengths of stay are from the 2006 National Centers for Medicare and Medicaid Services data. The probability of CBD stones was varied from 0% to 100% and the most cost-effective strategy was determined at each probability.
resultsAcross the CBD stone probability range of 4% to 100%, LC with IOC ± ERCP was the most cost-effective. If the probability was 0%, LC alone was the most cost-effective. Our model was sensitive to 1 health input: specificity of IOC, and 3 costs: cost of hospitalization for LC with CBDE, cost of hospitalization for LC without CBDE, and cost of LC with IOC.
conclusionsThe most cost-effective treatment strategy for the majority of patients with symptomatic cholelithiasis is LC with routine IOC. If stones are detected, CBDE should be forgone and the patient referred for ERCP.
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Registered trials
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