Frontiers in medicine · 2025
Safety and efficacy comparison of single-stage and two-stage ERCP combined with laparoscopic cholecystectomy: a meta-analysis and systematic review.
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Tai Jian-Xiong, Zhang Qingxiang
Аннотация
OBJECTIVE: This meta-analysis aims to assess the safety and efficacy of single-stage and two-stage ERCP combined with laparoscopic cholecystectomy in the management of bile duct stones.
METHODS: A comprehensive search was conducted in PubMed, Embase, Cochrane Library, and Web of Science databases to identify prospective randomized controlled studies comparing the effectiveness of single-stage ERCP combined with laparoscopy, also known as Laparoscopic-Endoscopic Rendezvous (LERV), and the sequential two-step approach of ERCP followed by laparoscopic cholecystectomy (ERCP+LC). Stone clearance success rate, incidence of complications, occurrence of pancreatitis, and hyperamylasemia were analyzed using Stata software.
RESULTS: Nine studies involving a total of 1,003 participants were included in the analysis, with 505 patients undergoing sequential surgery and 498 patients receiving LERV treatment. The LERV group exhibited a significantly higher stone clearance rate compared to the sequential surgery group (RR = 0.62, 95% CI: 0.49-0.79). The incidence of pancreatitis was significantly higher in the sequential surgery group compared to LERV (RR = 1.90, 95% CI: 1.61-2.24). Similarly, the occurrence of hyperamylasemia was significantly higher in the sequential surgery group compared to LERV (RR = 1.93, 95% CI: 1.55-2.40).
CONCLUSION: The findings of this meta-analysis support the effectiveness of LERV as a treatment option for bile duct stones. LERV demonstrates superior outcomes compared to the sequential two-step approach of ERCP followed by laparoscopic cholecystectomy (ERCP+LC). Specifically, LERV shows improved stone clearance success rates and a decreased incidence of pancreatitis. These results suggest that LERV is a safe and efficient procedure for the management of bile duct stones.
SYSTEMATIC REVIEW REGISTRATION: 2025100075, https://doi.org/10.37766/inplasy2025.10.0075.
METHODS: A comprehensive search was conducted in PubMed, Embase, Cochrane Library, and Web of Science databases to identify prospective randomized controlled studies comparing the effectiveness of single-stage ERCP combined with laparoscopy, also known as Laparoscopic-Endoscopic Rendezvous (LERV), and the sequential two-step approach of ERCP followed by laparoscopic cholecystectomy (ERCP+LC). Stone clearance success rate, incidence of complications, occurrence of pancreatitis, and hyperamylasemia were analyzed using Stata software.
RESULTS: Nine studies involving a total of 1,003 participants were included in the analysis, with 505 patients undergoing sequential surgery and 498 patients receiving LERV treatment. The LERV group exhibited a significantly higher stone clearance rate compared to the sequential surgery group (RR = 0.62, 95% CI: 0.49-0.79). The incidence of pancreatitis was significantly higher in the sequential surgery group compared to LERV (RR = 1.90, 95% CI: 1.61-2.24). Similarly, the occurrence of hyperamylasemia was significantly higher in the sequential surgery group compared to LERV (RR = 1.93, 95% CI: 1.55-2.40).
CONCLUSION: The findings of this meta-analysis support the effectiveness of LERV as a treatment option for bile duct stones. LERV demonstrates superior outcomes compared to the sequential two-step approach of ERCP followed by laparoscopic cholecystectomy (ERCP+LC). Specifically, LERV shows improved stone clearance success rates and a decreased incidence of pancreatitis. These results suggest that LERV is a safe and efficient procedure for the management of bile duct stones.
SYSTEMATIC REVIEW REGISTRATION: 2025100075, https://doi.org/10.37766/inplasy2025.10.0075.