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Use CBD exploration to manage common bile duct stones.

In many hospitals, a two-stage approach to clear CBD stones and remove the gallbladder has been the norm. Typically, endoscopic stone removal is followed by laparoscopic cholecystectomy 2-5 days later.

A single-stage approach, using laparoscopic common bile duct exploration, tackles both procedures at once.

How is laparoscopic common bile duct exploration different than the two-stage approach?

  • Both approaches are equally effective in clearing CBD stones. However, stones reoccur more often with the two-stage approach.1
  • Overall costs are higher with the two-stage approach.2 Studies also suggest the single-stage approach is underused3 in the management of CBD stones, while offering the overall benefits of fewer procedures, and reduced hospitalization duration and cost.2,3
  • Single-stage management of CBD stones can result in fewer procedures and higher patient satisfaction compared to two-stage management without increase in complications.4

Whatever approach you choose, Cook’s stone management offering gives you minimally invasive solutions to help you reduce the risk of bile duct injury (BDI). These products are sold as kits and as individual components to fit your preference.


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    Set components:

    1. Ding G, Cai W, Qin M. Single-stage vs. two-stage management for concomitant gallstones and common bile duct stones: a prospective randomized trial with long-term follow-up. J Gastrointest Surg. 2014:18(5):947-951.
    2. Rogers SJ, Cello JP, Horn JK, et al. Prospective randomized trial of LC+LCBDE vs ERCP/S+LC for common bile duct stone disease. Arch Surg. 2010;145(1):28-33.
    3. Gilsdorf D, Henrichsen J, Liljestrand K, et al. Laparoscopic common bile duct exploration for choledocholithiasis: analysis of practice patterns of Intermountain HealthCare. J Am Coll Surg. 2018;226(6):1160-1165.
    4. Salem MM, Esmat ME, Hassan AMA, et al. Comparative study between laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy for choledocholithiasis. Int Surg J. 2019;6(7):2250–2257.