Evidence map›Paper›PMID 39289226›Full record

ArticleSurgical endoscopy2024

Conquering the common bile duct: outcomes in minimally invasive transcystic common bile duct exploration versus ERCP.

Jana DeJesus, Keenan Horani, Kush Brahmbhatt, Camila Franco Mesa, Sarah Samreen, Jennifer M Moffett

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jana DeJesusDepartment of Surgery, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-1172, USA.
Keenan HoraniSchool of Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-1172, USA.
Kush BrahmbhattSchool of Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-1172, USA.
Camila Franco MesaDepartment of Surgery, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-1172, USA.
Sarah SamreenDepartment of Surgery, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-1172, USA.
Jennifer M MoffettDepartment of Surgery, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-1172, USA. jmmoffet@utmb.edu.ORCID 0009-0009-3545-9237

Funding

SURGICAL TRAINING IN GASTROINTESTINAL ENDOCRINOLOGYT32DK007639 · NIDDK · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI RADHAKRISHNAN, RAVI S. · 1992 to 2022
$3.6M
NIDDK NIH HHS T32 DK007639
6 · The paper itself

Abstract

introductionGiven the increasing interest for surgeons to reclaim the common bile duct in managing choledocholithiasis, there is a growing movement to perform common bile duct exploration (CBDE). Advantages of concomitant CBDE with cholecystectomy include fewer anesthetic events and decreased length of stay. As there is a paucity of literature evaluating the use of the robotic platform for CBDE, our study aims to compare intraoperative and post-operative outcomes between robotic-assisted one-stage and two-stage management of choledocholithiasis.

methodsA retrospective chart review was performed from May 1, 2022 to December 31, 2023, identifying patients with choledocholithiasis who underwent robot-assisted laparoscopic cholecystectomy and transcystic CBDE with choledochoscopy (one-stage management). Preoperative, intraoperative, and post-operative variables were compared to a control group of subjects with choledocholithiasis who underwent laparoscopic cholecystectomy with pre- or post-operative ERCP (two-stage management). Statistical analysis was performed using Chi-squared, Fisher's exact, Student's T, or Mann-Whitney test.

resultsFifty-three subjects who underwent one-stage management and 101 subjects who underwent two-stage management met inclusion criteria. Groups had similar demographics and medical history. Time to CBD clearance (45.2 h vs 47.0 h, p = .036), total length of stay (3.9 days vs 5.1 days, p = .007), fluoroscopy time (70.3 s vs 151.4 s, p < .001), and estimated radiation dose (23.0 mSv vs 40.3 mSv, p = .002) were significantly lower in the one-stage group compared to two-stage. Clearance rates, complication rates, and 30-day readmission rates were similar for both groups. Total length of stay and radiation exposure remained significantly lower on subanalysis comparing one-stage management to two-stage management with ERCP either before or after cholecystectomy.

conclusionRobotic-assisted laparoscopic cholecystectomy with transcystic common bile duct exploration via choledochoscopy is a safe and feasible option in the management of choledocholithiasis. It offers a shorter time to duct clearance, shorter length of stay, and less radiation exposure when compared to two-stage management.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeCholecystectomy, LaparoscopicCholedocholithiasisCommon Bile DuctRobotic Surgical ProceduresAdultAgedFemaleHumansLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsRetrospective StudiesTreatment OutcomeCBDECholedocholithiasisCholedochoscopyERCPRobot-assisted laparoscopic cholecystectomyRobotic surgeryTranscystic common bile duct exploration

Identifiers

PMID39289226

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.