{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:09:51Z","timestamp":1783490991320,"version":"3.55.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>The management of CBDS (common bile duct stones) in patients with co-existing gallbladder stones has been debated. Guidelines recommend patients with CBDS identified on imaging should be offered duct clearance; however, this is based on low-quality evidence. This study aimed to investigate the natural history of small CBDS identified using IOUS (intraoperative ultrasound) in patients undergoing cholecystectomy. This may provide evidence to support a short-term expectant management approach in such patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with CBDS diagnosed on IOUS during cholecystectomy were identified from a database of consecutive patients undergoing surgery. Patients with CBDS identified were divided into small stone (SS, \u22645 mm) and large stone (LS, &gt;5 mm) groups. Intraoperative CBDS management, postoperative investigations, postoperative bile duct clearance, re-admissions, complications, length of stay (LOS) and follow-up are described.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Fifty-nine of 427 patients had CBDS identified on IOUS. In the SS group (<jats:italic>n<\/jats:italic>=51), 46 patients underwent short-term expectant management rather than immediate\/planned bile duct clearance. Following short-term expectant management, 41\/46 patients (89.1%) did not require postoperative endoscopic retrograde cholangiopancreatography and at &gt;3 year follow-up, none has since presented with residual CBDS. Median LOS was 0 days in the short-term expectant management group and 2 days in the immediate\/planned bile duct clearance group, <jats:italic>P=<\/jats:italic>0.039.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study reports the natural history of small CBDS identified on IOUS in patients undergoing cholecystectomy. Such patients were safely treated with short-term expectant management associated with a reduced hospital LOS. This provides rationale for undertaking further research to establish this as a preferred management strategy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00423-024-03260-9","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T06:03:50Z","timestamp":1708581830000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Management of intraoperatively identified small bile duct stones in patients undergoing cholecystectomy"],"prefix":"10.1007","volume":"409","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-2753","authenticated-orcid":false,"given":"David","family":"Bunting","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abidemi","family":"Adesuyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Findlay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Pawlak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sanders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,22]]},"reference":[{"key":"3260_CR1","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1136\/gutjnl-2016-312317","volume":"66","author":"E Williams","year":"2017","unstructured":"Williams E, Beckingham I, Sayed G, Gurusamy K, Sturgess R, Webster G, Young T (2017) BSG Updated guideline on the management of common bile duct stones. 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World J Gastroenterol 14:2131\u20132140. https:\/\/doi.org\/10.3748\/wjg.v27.i18.2131","journal-title":"World J Gastroenterol"},{"key":"3260_CR8","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1308\/rcsann.2016.0068","volume":"98","author":"K Jamal","year":"2016","unstructured":"Jamal K, Smith H, Ratnasingham K (2016) Meta-analysis of the diagnostic accuracy of laparoscopic ultrasonography and intraoperative cholangiography in detection of common bile duct stones. Ann R Coll Surg Eng 98:244\u2013249. https:\/\/doi.org\/10.1308\/rcsann.2016.0068","journal-title":"Ann R Coll Surg Eng"},{"issue":"29","key":"3260_CR9","doi-asserted-by":"publisher","first-page":"5438","DOI":"10.3748\/wjg.v23.i29.5438","volume":"23","author":"A Dili","year":"2017","unstructured":"Dili A, Bertrand C (2017) Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy. 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Mr John Findlay is a board member and a sub-committee member of the British Hernia Society. Mr David Sanders received consultancy fees from Medtronic for checking wording of instructions for use of hernia related products and payment for online lectures as part of Hernia Basecamp and for industry symposia related to ProGrip mesh. Mr Sanders is President and a trustee of the British Hernia Society. Mr David Bunting is President and a trustee of the British Association of Day Surgery.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"70"}}