title: Laparoscopic common bile duct exploration.
abstract: BACKGROUND
  Laparoscopic common bile duct exploration (LCBDE) is a safe and effective single-stage treatment for choledocholithiasis in the elective setting. The outcomes after LCBDE in the emergency setting are unknown. The aim of this study was to compare the outcomes following elective and emergency LCBDE for choledocholithiasis.
  
  
  METHODS
  Details of all patients who underwent LCBDE for choledocholithiasis between August 2003 and August 2013 were analysed retrospectively. The primary outcome measure was common bile duct (CBD) stone clearance rate. Secondary outcome measures were conversion rate, morbidity, mortality and length of hospital stay.
  
  
  RESULTS
  Some 215 consecutive patients (57 male; median age 65 (range 14-92) years) underwent LCBDE. Some 121 procedures were performed electively and 94 as an emergency. Forty-five patients (48 per cent) presented with obstructive jaundice or cholangitis in the emergency LCBDE group compared with 15 (12·4 per cent) in the elective group (P < 0·001). The CBD stone clearance rate was similarly high in both groups (96 versus 96·7 per cent respectively; P = 0·557). There were no significant differences in conversion rate (6 versus 4·1 per cent), morbidity (5 versus 6·6 per cent), mortality (2 versus 0 per cent) or median length of stay (3 days) between groups. Two patients died, both following emergency LCBDE.
  
  
  CONCLUSIONS
  LCBDE can be performed safely and effectively in both elective and emergency settings.
authors.affiliation: Department of Surgery, Wrexham Maelor Hospital, Wrexham, LL13 7TD, UK.
authors.forename: D S Y
authors.initials: DS
authors.lastname: Chan
authors.forename: P A
authors.initials: PA
authors.lastname: Jain
authors.forename: A
authors.initials: A
authors.lastname: Khalifa
authors.forename: R
authors.initials: R
authors.lastname: Hughes
authors.forename: A L
authors.initials: AL
authors.lastname: Baker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042883:Choledocholithiasis / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000379:methods; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult