SynthesisBMC surgery2026
Laparoscopic one-stage (intraoperative-cholangiopancreatography / laparoscopic cholecystectomy or laparoscopic common bile duct exploration / laparoscopic cholecystectomy) vs. two-stage (pre-op cholangiopancreatography → laparoscopic cholecystectomy) for choledocholithiasis: a systematic review and meta-analysis.
Synthesis in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
- When Enzymes Mislead: Assessing the Value of MRCP in Suspected Choledocholithiasis.ANZ journal of surgery · 2026Article
- Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGiven the limitations of previous meta-analyses and the rapid global expansion of advanced laparoscopic technology, there is a clear need for an updated systematic review focusing on recent evidence. This study aims to provide a comprehensive and contemporary synthesis comparing one-stage and two-stage laparoscopic approaches for the management of choledocholithiasis. MATERIALS AND
methodsSubgroup and sensitivity analyses were performed to assess the stability and consistency of pooled outcomes across the included randomized controlled trials. Statistical synthesis was conducted using the Mantel–Haenszel method for categorical variables and the inverse-variance model for continuous outcomes under a fixed-effect framework. Heterogeneity was evaluated using Cochrane’s Q test and I² statistics, and potential publication bias was explored visually through funnel plots. All statistical procedures and graph generation were carried out using RevMan 5.4 software (Cochrane Collaboration, UK).
resultsA total of 12 randomized controlled trials involving 1,238 patients were included in this systematic review and meta-analysis comparing LC(laparoscopic cholecystectomy) + iERCP(intraoperative-Cholangiopancreatography )with LC(laparoscopic cholecystectomy) + pERCP(Pre-op Cholangiopancreatography )for choledocholithiasis. The success rate favored the one-stage approach (RR = 1.05 [0.97–1.09], I² = 19%, p = 0.29). Postoperative morbidity was significantly lower with iERCP (RR = 0.58 [0.35–0.95], Z = 2.14, p = 0.03, I² = 19%). The operative time was shorter in the two-stage strategy (MD = − 28.6 min [–45.2 to − 12.0], p = 0.0007, I² = 11%), while hospital stay was reduced with iERCP (MD = − 2.85 days [–3.92 to − 1.78], p < 0.001, I² = 17%).
conclusionThe one-stage laparoscopic–endoscopic approach (LC + iERCP) demonstrates superior efficacy and safety compared with the conventional two-stage strategy (LC + pERCP) for managing concurrent gallbladder and bile duct stones. By improving ductal clearance, reducing complications, and shortening hospitalization, it represents an optimized, patient-centered therapeutic option.
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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.