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Updated: May 24, 2026
Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
Published on: May 2, 2025
Meta-analysis of one- vs. two-stage laparoscopic/endoscopic management of common bile duct stones
Nicholas Alexakis1, Saxon Connor
1Department of Surgery, University of Athens School of Medicine, Hippocratio Hospital, Athens, Greece. nalexakis@yahoo.co.uk
Background:
The present study is a meta-analysis of English articles comparing one-stage [laparoscopic common bile duct exploration or intra-operative endoscopic retrograde cholangiopancreatography (ERCP)] vs. two-stage (laparoscopic cholecystectomy preceded or followed by ERCP) management of common bile duct stones.
Methods:
MEDLINE/PubMed and Science Citation Index databases (1990-2011) were searched for randomized, controlled trials that met the inclusion criteria for data extraction. Outcomes were calculated as odds ratios (ORs) with 95% confidence intervals (CIs) using RevMan 5.1.
Results:
Nine trials with 933 patients were studied. No significant differences was observed between the two groups with regard to bile duct clearance (OR, 0.89; 95% CI, 0.65-1.21), mortality (OR, 1.2; 95% CI, 0.32-4.52), total morbidity (OR, 0.75; 95% CI, 0.53-1.06), major morbidity (OR, 0.95; 95% CI, 0.60-1.52) and the need for additional procedures (OR, 1.58; 95% CI, 0.76-3.30).
Conclusions:
Outcomes after one-stage laparoscopic/endoscopic management of bile duct stones are no different to the outcomes after two-stage management.