title: A survey of European-African surgeons' management of common bile duct stones.
abstract: Common bile duct (CBD) stones can be managed by either endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic common bile duct exploration (LCBDE). The aim of this survey was to document the management of CBD stones by European-African HPB Association (E-AHPBA) members.
  
  
  
  All 331 members of the E-AHPBA were invited by personal email to participate to an online survey.
  
  
  
  Ninety-three (28%) surgeons replied within 2 months. Responding surgeons were attending surgeons (84%), working as HPB surgeons (75%) in academic hospitals (73%). In patients with clinically suspected CBD stones, MRCP was the preferred diagnostic test for 61% of respondents. LCBDE was the preferred therapeutic strategy for 11 (12%) respondents only. Previous gastric surgery was an absolute contraindication to ERCP for 47% of respondents. Absence of CBD dilation was considered an absolute contraindication for LCBDE in 24% of respondents. Yearly caseload exceeded 10 patients for only 30% of 56 centers performing LCBDE. The transcystic approach was preferred by 39% of surgeons performing LCBDE. There was considerable variation amongst respondents with regard to type and duration of drainage, bile duct closure technique and follow-up after LCBDE.
  
  
  
  Indications for single-stage LCBDE are not standardized and do not appear well established across E-AHPBA members.
authors.affiliation: Department of Abdominal Surgery, Jessa Ziekenhuis, Hasselt, Belgium.
authors.forename: Marie
authors.initials: M
authors.lastname: Vannijvel
authors.affiliation: Swiss HPB Center, Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland; Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, Lyon, France.
authors.forename: Mickael
authors.initials: M
authors.lastname: Lesurtel
authors.affiliation: Department of Abdominal Surgery, Jessa Ziekenhuis, Hasselt, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Bouckaert
authors.affiliation: Department of Abdominal Surgery, Jessa Ziekenhuis, Hasselt, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Houben
authors.affiliation: Department of Abdominal Surgery, Jessa Ziekenhuis, Hasselt, Belgium.
authors.forename: Joep
authors.initials: J
authors.lastname: Knol
authors.affiliation: Department of Abdominal Surgery, Jessa Ziekenhuis, Hasselt, Belgium.
authors.forename: Guido
authors.initials: G
authors.lastname: Vangertruyden
authors.affiliation: Department of Abdominal Surgery, Jessa Ziekenhuis, Hasselt, Belgium; Faculty of Medicine and Life Sciences, Universiteit Hasselt, Hasselt, Belgium. Electronic address: gregory.sergeant@jessazh.be.
authors.forename: Gregory
authors.initials: G
authors.lastname: Sergeant
mesh_terms: D000328:Adult; D000349:Africa; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000639:trends*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000639:trends*; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D005060:Europe; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends*; D066231:Surgeons / Q000639:trends*; D013997:Time Factors; D016896:Treatment Outcome; D016526:Workload