Frontiers in pediatrics · 2026
A comparative study of one-step vs. two-step approach in the treatment of pediatric gallbladder stones with common bile duct stones.
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Ju Junjun, Zhang Tao, Hu Xueyi, Chen Hualong, Ding Chenxi, Qi Shiqin, Pan Zhubin
Аннотация
OBJECTIVE: This study aims to compare the effects of the one-step and two-step methods of ERCP combined with laparoscopic cholecystectomy in the clinical application of pediatric gallbladder stones with common bile duct stones.
METHODS: Clinical data were retrospectively collected from pediatric patients diagnosed with gallbladder stones combined with common bile duct stones at our hospital from January 2023 to January 2026. Patients were divided into two groups based on the surgical approach: the one-step group (underwent ERCP and laparoscopic cholecystectomy under the same anesthesia) and the two-step group (underwent ERCP first, followed by laparoscopic cholecystectomy in a separate session). Baseline data and perioperative indicators were compared between the two groups.
RESULTS: A total of 76 pediatric patients were included in the study, with 29 patients in the one-step group and 47 patients in the two-step group. There were no significant differences in the preoperative baseline data (gender, age, BMI, common bile duct diameter, and preoperative liver function indicators) between the two groups (all P > 0.05). The total anesthesia time in the one-step group [320.0 (270.1, 337.5) mins] was significantly shorter than that of the two-step group [361.0 (324.4, 369.7) mins] (Z = -2.314, P = 0.019), and the length of hospitalization in the one-step group (5.3 ± 1.2) days was significantly shorter than the two-step group (6.8 ± 1.4) days (t = 4.784, P < 0.001). There were no significant differences between the two groups in total surgery time [273.2 (190.5, 320.4) mins vs. 287.3 (200.4, 347.1) mins, P = 0.9], postoperative stone clearance rate (89.6% vs. 87.2%, P = 0.249), postoperative complications (bile leakage, pancreatitis, cholangitis, etc.), postoperative liver function indicators (total bilirubin, direct bilirubin, AST, ALT), and hospitalization costs (all P > 0.05).
CONCLUSION: The one-step ERCP combined with laparoscopic cholecystectomy is safe and feasible in the treatment of pediatric gallbladder stones with common bile duct stones. The one-step method reduces the number of anesthesia sessions and anesthesia time, lowers the risk of general anesthesia in children, and shortens the length of hospitalization, making it worthy of clinical promotion in pediatrics.
METHODS: Clinical data were retrospectively collected from pediatric patients diagnosed with gallbladder stones combined with common bile duct stones at our hospital from January 2023 to January 2026. Patients were divided into two groups based on the surgical approach: the one-step group (underwent ERCP and laparoscopic cholecystectomy under the same anesthesia) and the two-step group (underwent ERCP first, followed by laparoscopic cholecystectomy in a separate session). Baseline data and perioperative indicators were compared between the two groups.
RESULTS: A total of 76 pediatric patients were included in the study, with 29 patients in the one-step group and 47 patients in the two-step group. There were no significant differences in the preoperative baseline data (gender, age, BMI, common bile duct diameter, and preoperative liver function indicators) between the two groups (all P > 0.05). The total anesthesia time in the one-step group [320.0 (270.1, 337.5) mins] was significantly shorter than that of the two-step group [361.0 (324.4, 369.7) mins] (Z = -2.314, P = 0.019), and the length of hospitalization in the one-step group (5.3 ± 1.2) days was significantly shorter than the two-step group (6.8 ± 1.4) days (t = 4.784, P < 0.001). There were no significant differences between the two groups in total surgery time [273.2 (190.5, 320.4) mins vs. 287.3 (200.4, 347.1) mins, P = 0.9], postoperative stone clearance rate (89.6% vs. 87.2%, P = 0.249), postoperative complications (bile leakage, pancreatitis, cholangitis, etc.), postoperative liver function indicators (total bilirubin, direct bilirubin, AST, ALT), and hospitalization costs (all P > 0.05).
CONCLUSION: The one-step ERCP combined with laparoscopic cholecystectomy is safe and feasible in the treatment of pediatric gallbladder stones with common bile duct stones. The one-step method reduces the number of anesthesia sessions and anesthesia time, lowers the risk of general anesthesia in children, and shortens the length of hospitalization, making it worthy of clinical promotion in pediatrics.