title: Ultrathin choledochoscope improves outcomes in the treatment of gallstones and suspected choledocholithiasis.
abstract: BACKGROUND
  We aimed to compare laparoscopic cholecystectomy (LC) and simultaneous laparoscopic transcystic common bile duct exploration (LTCBDE) using an ultrathin choledochoscope with LC followed by endoscopic retrograde cholangiopancreatography (ERC) and endoscopic sphincterotomy (ES) when indicated.
  
  
  METHODS
  We retrospectively reviewed the records of patients seen between 2004 and 2014 and treated with LC+LTCBDE or LC for gallstones and suspected choledocholithiasis. Postoperative complications and surgical outcomes were compared using t-test, Mann-Whitney U test, or chi-square test.
  
  
  RESULTS
  115 patients underwent successful LC+LTCBDE and 112 LC; follow-up data was available for 103 and 106 patients, respectively. Seventeen patients (16.5%) in the LC+LTCBDE group and 10 (28.6%) in the LC+ERC+ES group developed complications (P = 0.114). The LC+LTCBDE group had a significantly higher rate of satisfactory biliary function outcomes than the LC+ERC+ES group (98.1% vs. 85.7%, respectively) (P = 0.017).
  
  
  CONCLUSIONS
  Single-step LC+LTCBDE using an ultrathin choledochoscope may provide better outcomes in patients with gallstones and suspected choledocholithiasis.
authors: a Hospital and Institute of Hepatobiliary Surgery , Chinese PLA General Hospital, Chinese PLA Medical School , Beijing , China.
authors: Hong-Tian
authors: HT
authors: Xia
authors: a Hospital and Institute of Hepatobiliary Surgery , Chinese PLA General Hospital, Chinese PLA Medical School , Beijing , China.
authors: Bin
authors: B
authors: Liang
authors: a Hospital and Institute of Hepatobiliary Surgery , Chinese PLA General Hospital, Chinese PLA Medical School , Beijing , China.
authors: Yang
authors: Y
authors: Liu
authors: a Hospital and Institute of Hepatobiliary Surgery , Chinese PLA General Hospital, Chinese PLA Medical School , Beijing , China.
authors: Tao
authors: T
authors: Yang
authors: a Hospital and Institute of Hepatobiliary Surgery , Chinese PLA General Hospital, Chinese PLA Medical School , Beijing , China.
authors: Jian-Ping
authors: JP
authors: Zeng
authors: a Hospital and Institute of Hepatobiliary Surgery , Chinese PLA General Hospital, Chinese PLA Medical School , Beijing , China.
authors: Jia-Hong
authors: JH
authors: Dong
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation*; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D020776:Endoscopes, Gastrointestinal; D004867:Equipment Design; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects; D016896:Treatment Outcome
keywords: Choledocholithiasis; laparoscopic cholecystectomy; laparoscopic transcystic common bile duct exploration; ultrathin choledochoscope