Table 1.
Summary of randomized trials comparing two-stage (endoscopic common duct clearance and laparoscopic cholecystectomy) vs. one-stage (laparoscopic surgery alone or combined with intra-operative endoscopy)
| Study | Author | Year | Treatment | n | Duct clearance successful | Mortality | Morbidity (Total) | Morbidity (Major) | Additional procedures required | Length of stay (median, days) |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Rhodes | 1998 | LC+ERCP | 40 | 37 | 0 | 6 | 4 | 10 | 3.5 |
| LC+LCBDE | 40 | 30 | 0 | 7 | 2 | 10 | 1 | |||
| 2 | Cuschieri | 1999 | ERCP+LC | 133 | 82 | 2 | 17 | 9 | 17 | 9 |
| LC+LCBDE | 133 | 92 | 1 | 21 | 9 | 17 | 6 | |||
| 3 | Sgourakis | 2002 | ERCP+LC | 42 | 27 | 1 | 6 | 3 | 5 | 9 |
| LC+LCBDE | 36 | 24 | 1 | 5 | 2 | 4 | 7.4 | |||
| 4 | Nathanson | 2005 | LC+ERCP | 45 | 43 | 0 | 11 | 6 | 3 | 7.7 |
| LC+LCBDE | 41 | 40 | 0 | 12 | 7 | 3 | 6.4 | |||
| 5 | Morino | 2006 | ERCP+LC | 45 | 36 | 0 | 4 | 2 | 15 | 8 |
| LC+ intra-operative ERCP | 46 | 44 | 0 | 5 | 4 | 2 | 4.3 | |||
| 6 | Noble | 2009 | ERCP+LC | 47 | 29 | 1 | 16 | 8 | 18 | 3 (PO stay) |
| LC+LCBDE | 44 | 38 | 0 | 23 | 8 | 0 | 5 (PO stay) | |||
| 7 | Rogers | 2010 | ERCP+LC | 55 | 30 | 0 | 5 | 0 | 1 | 5 |
| LC+LCBDE | 57 | 15 | 0 | 6 | 0 | 2 | 4 | |||
| 8 | Bansal | 2010 | ERCP+LC | 15 | 13 | 0 | 5 | 2 | 2 | 4 |
| LC+LCBDE | 15 | 14 | 0 | 6 | 2 | 1 | 4.2 | |||
| 9 | Tzovaras | 2011 | ERCP+LC | 49 | 45 | 0 | 6 | 5 | 5 | 5.5 |
| LC+ intra-operative ERCP | 50 | 47 | 1 | 7 | 6 | 3 | 4 | |||
| Totals | ||||||||||
| Two stage (endoscopy followed by Surgery) | 471 | 342 (72.6%) | 4 (0.8%) | 76 (16.1%) | 39 (8.3%) | 76 (16.1%) | ||||
| One stage (LCBDE or intra-operative endoscopy) | 462 | 344 (74.4%) | 3 (0.6%) | 92 (19.9%) | 40 (8.6%) | 42 (9%) | ||||
LC, laparoscopic cholecystectomy; ERCP, endoscopic retrograde cholangiopancreatography; LCBDE; laparoscopic common bile duct exploration; PO, post-operative stay.