Surgical versus endoscopic treatment of bile duct stones

The Cochrane Database of Systematic Reviews
David J MartinJ Toouli

Abstract

10% to 18% of patients undergoing cholecystectomy for gallstones have common bile duct (CBD) stones. Treatment options for these stones include pre- or post-operative endoscopic retrograde cholangiopancreatography (ERCP) or open or laparoscopic surgery. To systematically review the management of CBD stones by four approaches: (1) ERCP versus open surgical bile duct clearance. (2) Pre-operative ERCP versus laparoscopic bile duct clearance. (3) Post-operative ERCP versus laparoscopic bile duct clearance. (4) ERCP versus laparoscopic bile duct clearance in patients with previous cholecystectomy. We systematically searched key relevant electronic databases, bibliographies of relevant papers, and abstracts of relevant subspecialty meetings until November 2005. The quality of included trials was assessed by adequacy of allocation sequence generation, allocation concealment, blinding, and follow-up. Published and unpublished data relevant to 12 predefined outcome measures were used to conduct fixed- and random-effects models meta-analyses, with exploration of heterogeneity and use of sensitivity and subgroup analysis where required. Thirteen trials randomised 1351 patients. Eight trials (n = 760) compared ERCP with open surgical clear...Continue Reading

Citations

Sep 19, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Casey B Duncan, Taylor S Riall
Apr 18, 2012·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Majid A AlmadiAlan N Barkun
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