title: Single-session laparoscopic cholecystectomy and ERCP: a valid option for the management of choledocholithiasis.
abstract: OBJECTIVE
  The option for performing ERCP and laparoscopic cholecystectomy (LC) for the management of choledocholithiasis in the same operative session is often overlooked. We compared the success, safety, and cost of ERCP and LC when performed in either a single session or in separate sessions.
  
  
  METHODS
  We conducted a retrospective cohort study at a U.S. tertiary care hospital. We identified patients undergoing ERCP and LC between April 2011 and August 2014 in either a single operative session (n = 33) or in 2 separate sessions within a 30-day period (n = 80). Technical success, total anesthesia duration, operative time, length of hospitalization, cost of care, and morbidity and mortality were evaluated.
  
  
  RESULTS
  Bile duct clearance was achieved in all patients at ERCP in the same-session cohort. The separate versus single-session groups, respectively, did not differ in terms of total procedure times (mean ± SD = 142 ± 64 vs 142 ± 58 min; t test, P =.98), anesthesia duration (251 ± 64 vs 225 ± 69 min; P =.06), or overall cost (49.3 ± 24.5 vs 42.3 ± 23.2 ×1000 USD; P =.167), but hospitalization was longer in the separate-sessions group (6.2 ± 3.3 vs 4.8 ± 2.6 days; P =.03). The rates of adverse events were similarly low (7% vs 2%, P =.70).
  
  
  CONCLUSIONS
  Performing single-session ERCP and LC is safe, effective, economically viable, and reduces hospital stay compared with performing ERCP and LC during separate sessions.
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Reema
authors.initials: R
authors.lastname: Mallick
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA; Division of Gastroenterology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Rank
authors.affiliation: School of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Carrie
authors.initials: C
authors.lastname: Ronstrom
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA; Division of Gastroenterology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Stuart K
authors.initials: SK
authors.lastname: Amateau
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA; Division of Gastroenterology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Arain
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA; Division of Gastroenterology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Attam
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA; Division of Gastroenterology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Freeman
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: James V
authors.initials: JV
authors.lastname: Harmon
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D042883:Choledocholithiasis / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization; D006801:Humans; D007430:Intraoperative Care; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods; D062606:Tertiary Care Centers