The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasis
Abstract Background Over the past 20 years, one-stage laparoscopic common bile duct exploration (LCBDE) combined with laparoscopic cholecystectomy (LC) has gained wide acceptance for the management of cholecystocholedocholithiasis (CCL). Despite this, the two-stage endo-laparoscopic approach, consis...
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BMC
2025-07-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-025-03094-2 |
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| author | Medhat Anwar Shaimaa Abdelaziz Abdelmoneim Mahmoud Hamida Mohamed Samir Mohamed Abu Deeba Magdy Hassan Mohamed Hany Bart Torensma Mohamed Hefzy |
| author_facet | Medhat Anwar Shaimaa Abdelaziz Abdelmoneim Mahmoud Hamida Mohamed Samir Mohamed Abu Deeba Magdy Hassan Mohamed Hany Bart Torensma Mohamed Hefzy |
| author_sort | Medhat Anwar |
| collection | DOAJ |
| description | Abstract Background Over the past 20 years, one-stage laparoscopic common bile duct exploration (LCBDE) combined with laparoscopic cholecystectomy (LC) has gained wide acceptance for the management of cholecystocholedocholithiasis (CCL). Despite this, the two-stage endo-laparoscopic approach, consisting of endoscopic retrograde cholangiopancreatography (ERCP) followed by LC, remains the most commonly used strategy. This study aims to analyze the efficacy of one-stage laparoscopic management versus two-stage endo-laparoscopic management of CCL. Methods This study included 100 patients with CCL, with data collected retrospectively for those admitted between January 2018 and December 2020, and prospectively between January 2021 and June 2021 at the Surgical Department of the Medical Research Institute Hospital, University of Alexandria. Patients were divided into two groups: Group A, who underwent two-stage management (ERCP followed by LC), and Group B, who underwent one-stage management (LCBDE and LC). Outcomes compared included procedural success, duration, hospital stay, and cost. Results In our economic analysis, the one-stage laparoscopic strategy demonstrated substantially lower costs ($3,636) compared to the two-stage approach ($5,682), representing a savings of $2,046 per patient. Procedural failure and conversion to open surgery occurred in 4% of Group B patients (2 cases) compared to 8% of Group A patients (4 cases). The median duration of the one-stage procedure was longer at 155 min compared to 95 min for the two-stage procedure. Hospital stay was comparable, with a median of 3 days in both groups. Readmissions were rare, with no cases in the one-stage group and one case in the two-stage group. Conclusions The one-stage laparoscopic approach for managing CBD stones and gallstones offers substantial cost savings compared to the two-stage approach ($2,046 per patient). This approach presents a viable option for healthcare systems that prioritize resource efficiency. |
| format | Article |
| id | doaj-art-959a2eca7a784bf8ae2d2f0644e62a83 |
| institution | DOAJ |
| issn | 1471-2482 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj-art-959a2eca7a784bf8ae2d2f0644e62a832025-08-20T03:04:21ZengBMCBMC Surgery1471-24822025-07-012511510.1186/s12893-025-03094-2The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasisMedhat Anwar0Shaimaa Abdelaziz Abdelmoneim1Mahmoud Hamida2Mohamed Samir3Mohamed Abu Deeba4Magdy Hassan5Mohamed Hany6Bart Torensma7Mohamed Hefzy8Medical Research Institute, Alexandria UniversityClinical Research Administration, Alexandria Directorate of Health Affairs, Egyptian Ministry of Health and PopulationMedical Research Institute, Alexandria UniversityMedical Research Institute, Alexandria UniversityMedical Research Institute, Alexandria UniversityMedical Research Institute, Alexandria UniversityMedical Research Institute, Alexandria UniversityClinical Epidemiology, Erasmus MCMedical Research Institute, Alexandria UniversityAbstract Background Over the past 20 years, one-stage laparoscopic common bile duct exploration (LCBDE) combined with laparoscopic cholecystectomy (LC) has gained wide acceptance for the management of cholecystocholedocholithiasis (CCL). Despite this, the two-stage endo-laparoscopic approach, consisting of endoscopic retrograde cholangiopancreatography (ERCP) followed by LC, remains the most commonly used strategy. This study aims to analyze the efficacy of one-stage laparoscopic management versus two-stage endo-laparoscopic management of CCL. Methods This study included 100 patients with CCL, with data collected retrospectively for those admitted between January 2018 and December 2020, and prospectively between January 2021 and June 2021 at the Surgical Department of the Medical Research Institute Hospital, University of Alexandria. Patients were divided into two groups: Group A, who underwent two-stage management (ERCP followed by LC), and Group B, who underwent one-stage management (LCBDE and LC). Outcomes compared included procedural success, duration, hospital stay, and cost. Results In our economic analysis, the one-stage laparoscopic strategy demonstrated substantially lower costs ($3,636) compared to the two-stage approach ($5,682), representing a savings of $2,046 per patient. Procedural failure and conversion to open surgery occurred in 4% of Group B patients (2 cases) compared to 8% of Group A patients (4 cases). The median duration of the one-stage procedure was longer at 155 min compared to 95 min for the two-stage procedure. Hospital stay was comparable, with a median of 3 days in both groups. Readmissions were rare, with no cases in the one-stage group and one case in the two-stage group. Conclusions The one-stage laparoscopic approach for managing CBD stones and gallstones offers substantial cost savings compared to the two-stage approach ($2,046 per patient). This approach presents a viable option for healthcare systems that prioritize resource efficiency.https://doi.org/10.1186/s12893-025-03094-2CholecystocholedocholithiasisLaparoscopicOne-stageCost-effectivenessEndoscopicSurgery |
| spellingShingle | Medhat Anwar Shaimaa Abdelaziz Abdelmoneim Mahmoud Hamida Mohamed Samir Mohamed Abu Deeba Magdy Hassan Mohamed Hany Bart Torensma Mohamed Hefzy The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasis BMC Surgery Cholecystocholedocholithiasis Laparoscopic One-stage Cost-effectiveness Endoscopic Surgery |
| title | The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasis |
| title_full | The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasis |
| title_fullStr | The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasis |
| title_full_unstemmed | The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasis |
| title_short | The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasis |
| title_sort | efficacy of one stage laparoscopic versus two stage endo laparoscopic management of cholecystocholedocholithiasis |
| topic | Cholecystocholedocholithiasis Laparoscopic One-stage Cost-effectiveness Endoscopic Surgery |
| url | https://doi.org/10.1186/s12893-025-03094-2 |
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