Two-stage vs single-stage management for concomitant gallstones and common bile duct stones

Table 1 Characteristics of 7 included randomized controlled trials

Included studies	Country	Study period	Sample size	Comparison	Measured outcomes
Bansal et al[5], 2010	India	2007-2008	30	Preoperative ERCP/EST + LC (n = 15) vs LC + LCBDE (n = 15)	Successful removal of gallbladder and CBD clearance, complications
Rogers et al[24], 2010	United States	1997-2003	122	Preoperative ERCP/EST + LC (n = 61) vs LC + LCBDE (n = 61)	Stone clearance from CBD, length of hospital stay, cost of index hospitalization, hospital charges, professional fees, patient acceptance, morbidity, mortality, quality of life scores
Rhodes et al[25], 1998	United Kingdom	1995-1997	80	Postoperative ERCP/EST + LC (n = 40) vs LC + LCBDE (n = 40)	Duct-clearance rates, morbidity, operating time and hospital stay
Cuschieri et al[26], 1999	Scotland	1994-1997	300	Preoperative ERCP/EST + LC (n = 150) vs LC + LCBDE (n = 150)	Hospital stay, success rates, conversion rates, morbidity and mortality
Nathanson et al[27], 2005	Australia	1998-2003	86	Postoperative ERCP/EST + LC (n = 45) vs LC + LCBDE (n = 41)	Operative time, morbidity, retained stone rate, reoperation rate and hospital stay
Sgourakis et al[28], 2002	Greece	1997-2000	78	Preoperative ERCP/EST + LC (n = 42) vs LC + LCBDE (n = 36)	Stone clearance, morbidity, mortality, conversion, hospital stay, complications
Noble et al[29], 2009	United Kingdom	2000-2006	91	Preoperative ERCP/EST + LC (n = 47) vs LC + LCBDE (n = 44)	Duct clearance, complications, number of procedures per patient, conversion and hospital stay

RCTs: Randomized controlled trial; CBD: Common bile duct; LC: Laparoscopic cholecystectomy; ERCP: Endoscopic retrograde cholangiopancreatography; EST: Endoscopic sphincterotomy; LCBDE: Laparoscopic common bile duct exploration.

Table 2 Outcomes of 7 included randomized controlled trials (endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomy + laparoscopic cholecystectomy) vs (laparoscopic cholecystectomy+ laparoscopic common bile duct exploration)

Included studies	Stone clearance from the CBD (%)	Postoperative morbidity (%)	Mortality (%)	Conversion to other procedures (%)	Number of procedures per patient	Length of hospital stay (d)	Total operating time (min) (SD or range)	Hospitalization charges ($) (SD or range)
Bansal et al[5], 2010	86.7 vs 93.3	Not mentioned	0 vs 0	15.4 vs 6.7	Not mentioned	4 (2-11) vs 4.2 (3-9)	153 (120-240) vs ?	Not mentioned
Rogers et al[24], 2010	96.8 vs 88.2	9.1 vs 10.5	0 vs 0	1.8 vs 3.5	2.0 vs 1.0	4.1 (3.5) vs 2.3 (1.9)	183 (39) vs 174 (67)	30 617 (16 384) vs 27 675 (11 256)
Rhodes et al[25], 1998	75 vs 75	15 vs 17.5	Not mentioned	0 vs 25	2.4 vs 1.3	3.5 (1-11) vs 1 (1-26)	105 (60-255) vs 90 (25-310)	Not mentioned
Cuschieri et al[26], 1999	83.7 vs 82.6	12.5 vs 15.8	1.5 vs 0.8	14.7 vs 15	2.0 vs 1.2	9 (5.5-14) vs 6 (4.2-12)	Not mentioned	Not mentioned
Nathanson et al[27], 2005	71.1 vs 97.6	13.3 vs 17.1	0 vs 0	6.7 vs 4.9	2.3 vs 1.2	7.7 vs 6.4	147.9 vs 158.8	Not mentioned
Sgourakis et al[28], 2002	84.3 vs 85.7	18.8 vs 17.9	3.1 vs 0	15.6 vs 14.3	2.1 vs 1.1	9 vs 7.4	105 (60-255) vs 90 (70-310)	Not mentioned
Noble et al[29], 2009	55.6 vs 100	29.8 vs 43.2	Not mentioned	42.6 vs 9.1	2.3 vs 1.0	3 (2-7) vs 5 (2-7)	Not mentioned	Not mentioned

CBD: Common bile duct.

Table 3 Cochrane risk of bias summary

Included studies	Random sequence generation	Allocation concealment	Blinding of participants and personnel	Blinding of outcome assessment	Incomplete outcome data	Selective reporting	Other bias
Bansal et al[5], 2010	Low risk	Low risk	High risk	Unclear risk	High risk	High risk	Unclear risk
Rogers et al[24], 2010	Low risk	Low risk	High risk	Unclear risk	High risk	Low risk	Low risk
Rhodes et al[25], 1998	Unclear risk	Unclear risk	High risk	Unclear risk	Low risk	High risk	Unclear risk
Cuschieri et al[26], 1999	Low risk	Unclear risk	High risk	Unclear risk	Low risk	High risk	Unclear risk
Nathanson et al[27], 2005	Low risk	Low risk	High risk	Unclear risk	Low risk	High risk	Unclear risk
Sgourakis et al[28], 2002	High risk	Unclear risk	High risk	Unclear risk	High risk	High risk	Low risk
Noble et al[29], 2009	Low risk	Unclear risk	High risk	Unclear risk	Low risk	High risk	Low risk