title: How can recovery be enhanced after single-stage laparoscopic management of CBD stones? Endoscopic treatment versus laparoscopic surgery.
abstract: BACKGROUND
  Single-stage management of CBD stones comprises simultaneous common bile duct (CBD) clearance and cholecystectomy. The CBD can be cleared by using endoscopic treatment (ET) or laparoscopic surgery (LS) alone.
  
  
  OBJECTIVE
  To determine the most rapid recovery after the single-stage laparoscopic management of CBD stones.
  
  
  METHODS
  Patients with CBD stones treated at either of two centers (one performing ET only and one performing LS only for single-stage treatment) were included. The primary endpoint was "the textbook outcome".
  
  
  RESULTS
  The feasibility rate was 74% for ET and 100% for LS (p≤0.001). The proportion of cases with the textbook outcome was higher in the ET group than in the LS-only group (73% vs. 10%; p<0.001). The CBD clearance rate was similar in the ET and LS-only groups (100% vs. 96.6%, respectively; p=0.17). The overall morbidity rate was lower in the ET group than in the LS-only group (23% vs. 29%, p=0.05).
  
  
  CONCLUSIONS
  Both ET and LS are feasible, safe and effective for clearance of the CBD. ET was better than LS in terms of a less frequent requirement for drainage and a shorter length of hospital stay. LS was associated with a shorter operating time.
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Chapuis-Roux
authors.affiliation: Department of Digestive Surgery, Mutualist clinics, Lorient, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Pellissier
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Browet
authors.affiliation: Department of Digestive Surgery, Mutualist clinics, Lorient, France.
authors.forename: Jean Charles
authors.initials: JC
authors.lastname: Berthou
authors.affiliation: Department of Gastroenterology, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.
authors.forename: Sami
authors.initials: S
authors.lastname: Hakim
authors.affiliation: Department of Gastroenterology, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Brazier
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Cosse
authors.affiliation: Department of Gastroenterology, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Delcenserie
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France; EA4294, Jules Verne University of Picardie, Amiens, France; Clinical Research Centre, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France. Electronic address: regimbeau.jean-marc@chu-amiens.fr.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D042883:Choledocholithiasis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D055815:Young Adult
keywords: Common Bile duct stones; Endoscopic treatment