ArticleBMC surgery2025
The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasis.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.
What it found
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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
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.
Who cites it
2 citing papers in PubMed, 2 syntheses or guidelines pooled it.
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOver the past 20 years, one-stage laparoscopic common bile duct exploration (LCBDE) combined with laparoscopic cholecystectomy (LC) has gained wide acceptance for the management of cholecystocholedocholithiasis (CCL). Despite this, the two-stage endo-laparoscopic approach, consisting of endoscopic retrograde cholangiopancreatography (ERCP) followed by LC, remains the most commonly used strategy. This study aims to analyze the efficacy of one-stage laparoscopic management versus two-stage endo-laparoscopic management of CCL.
methodsThis study included 100 patients with CCL, with data collected retrospectively for those admitted between January 2018 and December 2020, and prospectively between January 2021 and June 2021 at the Surgical Department of the Medical Research Institute Hospital, University of Alexandria. Patients were divided into two groups: Group A, who underwent two-stage management (ERCP followed by LC), and Group B, who underwent one-stage management (LCBDE and LC). Outcomes compared included procedural success, duration, hospital stay, and cost.
resultsIn our economic analysis, the one-stage laparoscopic strategy demonstrated substantially lower costs ($3,636) compared to the two-stage approach ($5,682), representing a savings of $2,046 per patient. Procedural failure and conversion to open surgery occurred in 4% of Group B patients (2 cases) compared to 8% of Group A patients (4 cases). The median duration of the one-stage procedure was longer at 155 min compared to 95 min for the two-stage procedure. Hospital stay was comparable, with a median of 3 days in both groups. Readmissions were rare, with no cases in the one-stage group and one case in the two-stage group.
conclusionsThe one-stage laparoscopic approach for managing CBD stones and gallstones offers substantial cost savings compared to the two-stage approach ($2,046 per patient). This approach presents a viable option for healthcare systems that prioritize resource efficiency.
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