TPT 8.14 Index Laparoscopic Common Bile Duct Exploration Versus ERCP-First Strategy for Choledocholithiasis: A Retrospective Comparative Cohort Study with Propensity-Based Analyses

Clicks: 1
ID: 324037
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #395 of 432 articles by views in the british journal of surgery

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 432 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background ERCP followed by delayed cholecystectomy is a common pathway for choledocholithiasis, but exposes patients to recurrent biliary events and repeat interventions while awaiting definitive surgery. Laparoscopic common bile duct exploration (LCBDE) provides definitive single-stage management, but is variably adopted. We compared the outcomes of single-stage management versus two-stage management of choledocholithiasis. Methods We analysed prospectively maintained database of patients undergoing index ERCP or index LCBDE for choledocholithiasis. Patients with prior cholecystectomy, ERCP for non-stone indications, or a recent ERCP within 6 months were excluded; patients with multiple ERCPs contributed only the index ERCP. Outcomes were further acute biliary admissions, repeat ERCP procedures, additional imaging (ultrasound/MRI/CT), and additional hospital bed-days after the index admission. We used negative binomial regression with log (person-time) offsets; propensity overlap weighting estimated effects in the overlap population (ATO). Results The cohort comprised 390 patients (ERCP-first 352, LCBDE-first 38) contributing 731.0 person-years of follow-up. Crude readmission rates were 3.9 versus 18.7 per 100 person-years and bed-day rates were 9.1 versus 161.5 per 100 person-years (LCBDE-first vs ERCP-first). In adjusted models, LCBDE-first was associated with fewer readmissions (IRR 0.16, 95% CI 0.05-0.51) and fewer bed-days (IRR 0.05, 95% CI 0.02-0.18). Overlap-weighted analyses were directionally consistent; estimates for repeat ERCP and imaging were less precise. Conclusion In this observational cohort, the LCBDE-first strategy was associated with materially fewer subsequent admissions and bed-days than an ERCP-first pathway. Propensity-based analyses support these differences in the overlap population, but limited propensity overlap and unmeasured confounding warrant cautious causal interpretation.
Reference Key
openalex_W7172556750 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Charlotte Smith, Makthum Muwafikha Ismail, Khurram Shahzad Khan
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.271
URL
https://doi.org/10.1093/bjs/znag087.271
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.