title: One-stage laproendoscopic procedure versus two-stage procedure in the management for gallstone disease and biliary duct calculi: a systemic review and meta-analysis.
abstract: Laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography (ERCP) are secure and effective techniques that recently been used to treat bile duct stones. The purpose of this research was to assess the intra-procedural efficacy and postprocedural upshots of the laparoscopic common bile duct exploration plus laparoscopic cholecystectomy (LCBDE) and ERCP plus laparoscopic cholecystectomy (ERCP + LC).
  
  
  
  All studies contrasting one-stage (LCBDE) with two-stage (ERCP/EST + LC) managements in patients with concomitant gallstones and common bile duct (CBD) stones were included. The primary outcomes were CBD stone clearance, postoperative morbidity, and mortality, while secondary outcomes were conversion with other techniques, duration of stay in hospital, number of procedures used per patient, and operating time. Data were pooled by meta-analysis.
  
  
  
  Fourteen studies with 1600 participants were identified. Each arm contains 800 participants. There is no significant difference between the two arms regarding successful CBD stone clearance (RR = 0.96, P = 0.15), mortality (RR = 1.74, P = 0.33), morbidity (RR = 0.89, P = 0.32), conversion to additional procedure (RR = 1.44, P = 0.09), operating time (MD = -1.43 min, P = 0.95), hospital stay (MD = 1.31 days, P = 0.17), and retained stone rate (RR = 1.73, P = 0.38).
  
  
  
  One- and two-stage management had similar efficacy and safety in terms of CBD stone clearance rate, mortality, morbidity, operating time, hospital stay, and retained stone rate. One-stage management may reduce additional procedure.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Prasson
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
authors.forename: Xueli
authors.initials: X
authors.lastname: Bai
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. liangtingbo@zju.edu.cn.
authors.forename: Tingbo
authors.initials: T
authors.lastname: Liang
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041761:Cholecystolithiasis / Q000601:surgery*; D042883:Choledocholithiasis / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D061646:Operative Time
keywords: Bile duct stones; Endoscopic retrograde cholangiopancreatography; Laproendoscopy; Meta-analysis