Trial reportSurgical endoscopy2014
Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with concomitant gallbladder stones and common bile duct stones: a randomized controlled trial.
Trial report in Surgical endoscopy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04801238 (preGallstep), which is not on this map. Cited by 99 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
preGallstep: One-step Laparoscopic Cholecystectomy, Common Bile Duct Exploration and Stone Extraction Versus Two-step Endoscopic Retrograde Cholangiography and Stone Extraction Plus Laparoscopic Cholecystectomy for Common Bile Duct Stones
Who cites it
99 citing papers in PubMed, 12 syntheses or guidelines pooled it, 237 citations in OpenAlex.
- Minimally invasive surgical strategies for gallbladder stones with concomitant common bile duct stones: a systematic review and network meta-analysis.BMC surgery · 2026Pooled it
- Pooled it
- Safety and efficacy comparison of single-stage and two-stage ERCP combined with laparoscopic cholecystectomy: a meta-analysis and systematic review.Frontiers in medicine · 2025Pooled it
- EAES rapid guideline: updated systematic review, network meta-analysis, CINeMA and GRADE assessment, and evidence-informed European recommendations on the management of common bile duct stones.Surgical endoscopy · 2022Guideline
- Laparoscopic common bile duct exploration versus intraoperative endoscopic retrograde cholangiopancreatography in patients with gallbladder and common bile duct stones: a meta-analysis.Surgical endoscopy · 2021Pooled it
- Clinical spotlight review for the management of choledocholithiasis.Surgical endoscopy · 2020Pooled it
- Laparoscopic common bile duct exploration plus cholecystectomy versus endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy for cholecystocholedocholithiasis: a meta-analysis.Surgical endoscopy · 2019Pooled it
- ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis.Gastrointestinal endoscopy · 2019Guideline
- Pooled it
- Pooled it
- One-stage laproendoscopic procedure versus two-stage procedure in the management for gallstone disease and biliary duct calculi: a systemic review and meta-analysis.Surgical endoscopy · 2016Pooled it
- Systematic review with meta-analysis of studies comparing primary duct closure and T-tube drainage after laparoscopic common bile duct exploration for choledocholithiasis.Surgical endoscopy · 2016Pooled it
- Advantages of laparoscopic common bile duct exploration in common bile duct stones.Wiener klinische Wochenschrift · 2018Trial
- Single-stage management with combined tri-endoscopic approach for concomitant cholecystolithiasis and choledocholithiasis.Surgical endoscopy · 2016Trial
- Preoperative difficulty assessment of laparoscopic cholecystectomy after treatment for choledocholithiasis.Surgical endoscopy · 2026Article
- Transcystic and choledochotomy approaches of laparoscopic bile duct exploration show distinct outcomes against ERCP + laparoscopic cholecystectomy in a meta-analysis of randomised controlled trials.Updates in surgery · 2026Article
- Recurrent choledocholithiasis after laparoscopic bile duct exploration: incidence, risk factors, and management strategies.Surgical endoscopy · 2026Article
- Article
- Application of laparoscopy, choledochoscopy, and duodenoscopy in the treatment of gallstones with choledocholithiasis.Frontiers in surgery · 2026Article
- Review
39 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe ideal method for managing concomitant gallbladder stones and common bile duct (CBD) stones is debatable. The currently preferred method is two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy (LC). This prospective randomized trial compared the success and cost effectiveness of single- and two-stage management of patients with concomitant gallbladder and CBD stones.
methodsConsecutive patients with concomitant gallbladder and CBD stones were randomized to either single-stage laparoscopic CBD exploration and cholecystectomy (group 1) or endoscopic retrograde cholangiopancreatography (ERCP) for endoscopic extraction of CBD stones followed by LC (group 2). Success was defined as complete clearance of CBD and cholecystectomy by the intended method. Cost effectiveness was measured using the incremental cost-effectiveness ratio. Intention-to-treat analysis was performed to compare outcomes.
resultsFrom February 2009 to October 2012, 168 patients were randomized: 84 to the single-stage procedure (group 1) and 84 to the two-stage procedure (group 2). Both groups were matched with regard to demographic and clinical parameters. The success rates of laparoscopic CBD exploration and ERCP for clearance of CBD were similar (91.7 vs. 88.1 %). The overall success rate also was comparable: 88.1 % in group 1 and 79.8 % in group 2 (p = 0.20). Direct choledochotomy was performed in 83 of the 84 patients. The mean operative time was significantly longer in group 1 (135.7 ± 36.6 vs. 72.4 ± 27.6 min; p ≤ 0.001), but the overall hospital stay was significantly shorter (4.6 ± 2.4 vs. 5.3 ± 6.2 days; p = 0.03). Group 2 had a significantly greater number of procedures per patient (p < 0.001) and a higher cost (p = 0.002). The two groups did not differ significantly in terms of postoperative wound infection rates or major complications.
conclusionsSingle- and two-stage management for uncomplicated concomitant gallbladder and CBD stones had similar success and complication rates, but the single-stage strategy was better in terms of shorter hospital stay, need for fewer procedures, and cost effectiveness.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.