title: Meta-analysis of one- vs. two-stage laparoscopic/endoscopic management of common bile duct stones.
abstract: 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.
authors.affiliation: Department of Surgery, University of Athens School of Medicine, Hippocratio Hospital, Athens, Greece. nalexakis@yahoo.co.uk
authors.forename: Nicholas
authors.initials: N
authors.lastname: Alexakis
authors.forename: Saxon
authors.initials: S
authors.lastname: Connor
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000401:mortality; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000401:mortality; D003135:Common Bile Duct / Q000601:surgery*; D019317:Evidence-Based Medicine; D042882:Gallstones / Q000401:mortality / Q000601:surgery*; D006801:Humans; D016017:Odds Ratio; D016896:Treatment Outcome