Trends in choledocholithiasis management

Editor's Note

This study found a marked decline from 1998 to 2013 in surgical (open and laparoscopic) common bile duct exploration (CBDE) for choledocholithiasis (ie, bile duct stones).

At the same time, the rate of endoscopic retrograde cholangiopancreatography (ERCP) increased and is becoming the predominant treatment strategy.

The percentage of patients with choledocholithiasis having surgical CBDE decreased from 39.8% in 1998 to 8.5% in 2013.

From 2011 to 2013, patients undergoing laparoscopic CBDE with laparoscopic cholecystectomy ranged from 1.5% to 1.8%. Those having ERCP with laparoscopic cholecystectomy ranged for 84.3% to 85.7%.

If the trend continues, common bile duct exploration may disappear from the surgical armamentarium, the authors say.

1Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois 2Surgical Outcomes and Quality Improvement Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois 3Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, Illinois 4Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, Illinois 5Department of Surgery, University of California, Los Angeles 6Department of Surgery, VA Greater Los Angeles Healthcare System, Los Angeles, California 7Department of Surgery, Sunnybrook Health Sciences Centre, the University of Toronto, Toronto, Ontario, Canada