Publication:

Efficacy of single-stage laparoscopic common bile duct exploration versus sequential ERCP followed by cholecystectomy for the management of choledocholithiasis

Choledocholithiasis is one of the most frequent complications of cholelithiasis, and its optimal management remains a constant surgical challenge. Currently, there are two main strategies: single-stage laparoscopic common bile duct exploration (LCBDE) and the sequential approach consisting of endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy.To evaluate the comparative efficacy between the single-stage laparoscopic approach and sequential ERCP management in terms of technical success, complications, and hospital stay.A systematic review of scientific literature was conducted in indexed databases (PubMed, Scopus, Cochrane Library) using DeCS/MeSH descriptors. Studies published between 2020 and 2025 comparing both techniques in patients with confirmed choledocholithiasis were included.Evidence analysis indicates that the single-stage approach (LCBDE) offers similar efficacy in common bile duct clearance compared to sequential ERCP. However, LCBDE is associated with a significant reduction in total hospital stay and a lower rate of post-procedure pancreatitis. The sequential management, although more widespread, involves greater exposure to multiple anesthetic acts and an increase in overall operating costs. Single-stage laparoscopic common bile duct exploration is a safe and cost-efficient alternative for the treatment of choledocholithiasis. Its implementation should be promoted in centers that have the necessary equipment and surgeons with experience in advanced biliary tract techniques.