Single Stage Management of Concomitant Cholelithiasis and Choledocholithiasis.

Area of Science:

• Gastroenterology
• Surgical Innovation
• Minimally Invasive Surgery

Background:

• Cholelithiasis and choledocholithiasis are often treated sequentially with endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy.
• A single-stage approach integrates these procedures in one operating room session.

Purpose of the Study:

• To evaluate the feasibility, outcomes, and complications of a single-stage endoscopic and laparoscopic management for concomitant gallstones and common bile duct stones.

Main Methods:

• A prospective cross-sectional study included patients undergoing single-stage endoscopic and laparoscopic treatment.
• Data collected included patient demographics, procedural times, and post-operative complications.
• Statistical analysis was performed on the collected data.

Main Results:

• The single-stage procedure was successful in 48 out of 50 patients, with 2 requiring conversion to open surgery.
• The mean total procedural time was 90.93 minutes, shorter when laparoscopy preceded endoscopy.
• Seven patients experienced clinically significant complications, including cholangitis, pancreatitis (one severe), and duodenal perforation.

Conclusions:

• Single-stage endoscopic and laparoscopic management of common bile duct and gall bladder stones is feasible and yields acceptable results.
• Performing endoscopic common bile duct stone treatment first is associated with increased procedural time.