{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:14:44Z","timestamp":1791972884178,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:00:00Z","timestamp":1698364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Backgrounds<\/jats:title><jats:p>Laparoscopic common bile duct exploration (LCBDE) has been shown to be effective in managing choledocholithiasis whilst avoiding ERCP\u2010related complications. However, patient and technical factors effects outcome. This study aimed to explore the matters effecting the failure of LCBDE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent a laparoscopic cholecystectomy (LC) between 2007 and 2021 were identified using a prospective database. Data were collected for patients who underwent LCBDE including demographics, pre\u2010operative investigations, intra\u2010operative findings, technique of bile duct clearance and clearance rates, and post\u2010operative outcomes. Predictors of failed LCBDE were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Laparoscopic cholecystectomy was performed in 3648 patients. Of these, 374 underwent LCBDE for suspected choledocholithiasis. Choledochoscopy was most frequently used (58.8%) with a success rate of 84.1%. Small cystic duct diameter (4.7 vs. 3.4\u2009mm, <jats:italic>P<\/jats:italic>\u2009=\u20090.002), stone size &gt;6\u2009mm (<jats:italic>P<\/jats:italic>\u2009=\u20090.02), stone: cystic duct ratio &gt;1 (<jats:italic>P<\/jats:italic>\u2009=\u20090.04), and &gt;3 stones was associated with failed LCBDE by univariate analysis. Small cystic duct diameter (OR: 0.45, 95% CI: 0.26\u20130.77, <jats:italic>P<\/jats:italic>\u2009=\u20090.004) and stone size &gt;6\u2009mm (OR: 0.23, 95% CI: 0.06\u20130.92), <jats:italic>P<\/jats:italic>\u2009=\u20090.04) correlated with failure by multivariate analysis. Failed LCBDE was associated with increased length of stay (6.6\u2009days vs. 3.1\u2009days, <jats:italic>P<\/jats:italic>\u2009=\u20090.001), however the rate of serious complications or mortality was unaffected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LCBDE is safe and effective in managing choledocholithiasis. Factors such as cystic duct diameter, size and number of CBD stones, and stone: cystic duct ratio are associated with increased likelihood of inadequate clearance. The presence of these factors can help clinicians in decision making during LCBDE to improve chance of success.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18756","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T11:56:43Z","timestamp":1698407803000},"page":"375-379","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Laparoscopic common bile duct exploration: what factors determine success?"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4295-422X","authenticated-orcid":false,"given":"Pramudith","family":"Sirimanna","sequence":"first","affiliation":[{"name":"Department of Upper GI Surgery Concord Repatriation General Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3728-9058","authenticated-orcid":false,"given":"Hyerim","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Upper GI Surgery Concord Repatriation General Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory L.","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Upper GI Surgery Concord Repatriation General Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312317"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-014-3907-x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0862-0346"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002731"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6170-8"},{"key":"e_1_2_8_7_1","first-page":"260","article-title":"One\u2010step versus two\u2010step procedure for management procedures for management of concurrent gallbladder and common bile duct stones. 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