Introduction: The management of concomitant cholelithiasis and choledocholithiasis remains complex.
While laparoscopic cholecystectomy (LC) is the gold standard for gallstones, addressing common bile
duct (CBD) stones requires additional intervention. Single-session LC with intraoperative endoscopic
retrograde cholangiopancreatography (ERCP) offers cost-effectiveness, patient convenience, and low
complication rates, and has emerged as a promising alternative to traditional two-stage management.
Objective: To evaluate clinical outcomes of single-session LC combined with intraoperative ERCP in
patients with cholecystocholedocholithiasis.
Methods: A retrospective study was conducted on 42 patients undergoing single-session LC with ERCP
at a tertiary care center from January 2022 to December 2023. Data was recorded prospectively.
Primary outcomes included CBD clearance rates, complications, operative time, hospital stay, and
need for re-intervention.
Results: Of 42 patients (23 males, 19 females; mean age 47.3 ± 14.2 years), CBD clearance was
achieved in 95%. Median operative time was 180 minutes (IQR: 135–240). No major postoperative
complications were recorded. ERCP failed to clear stones in 2 cases. Three patients required conversion
to open surgery. Mean postoperative hospital stay was 2 days (range: 1–4). Five patients required reintervention
during follow-up.
Conclusion: Single-session LC with intraoperative ERCP is a safe and effective approach for managing
cholecystocholedocholithiasis. It achieves high clearance rates with minimal morbidity and reduced
hospital stay. Broader adoption is encouraged in centers equipped with the necessary expertise and
facilities.
