{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T19:39:35Z","timestamp":1785008375366,"version":"3.55.0"},"reference-count":9,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Approximately 10% of intraoperative cholangiograms identify choledocholithiasis (CDL), stones in the common bile duct. Choledocholithiasis management options include endoscopic retrograde cholangiopancreatography (ERCP) followed by cholecystectomy, laparoscopic cholecystectomy (LC) followed by ERCP (LC + ERCP), cholecystectomy with open common bile duct exploration, or laparoscopic cholecystectomy with laparoscopic common bile duct exploration (LC + LCBDE). The goal of these interventions is to clear the obstruction from CDL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients from a single-center community hospital undergoing LC with intraoperative cholangiogram (LC + IOC) progressing to LC + LCBDE from July 2020 to August 2022 were evaluated for hospital length of stay (LOS), operative times, and complications. These were compared to the prior standard practice of pre\/post-operative ERCP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results were evaluated using ANOVA, Student-Newman-Keuls, and chi square analysis. In comparison of LC + CBDE to ERCP + cholecystectomy, LOS was reduced (1.8 vs 4.6\u00a0days P &lt; .0001). No difference in LOS between LC + IOC and LC + CBDE (1.4 vs 1.8\u00a0days, P &gt; .05) was found. No difference in complication rates was found. Mean operative time differed between LC + IOC and LC + CBDE (63 vs 113\u00a0minutes, P &lt; .0001). Fifty-five attempts of LC + CBDE were performed with only 10 requiring post-operative ERCP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Since implementation of LC + CBDE, there has been reduced LOS without increasing complication rates. Operative times are increased with LC + CBDE but offset by reduced LOS, additional anesthesia events, and procedures. Our institution will continue to pursue LC + CBDE when indicated with efforts to improve resource allocation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348241241626","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T09:49:30Z","timestamp":1711964970000},"page":"2011-2013","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Management of Choledocholithiasis in a Community Hospital: Laparoscopic Common Bile Duct Exploration Versus Endoscopic Retrograde Cholangiopancreatography"],"prefix":"10.1177","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1302-367X","authenticated-orcid":false,"given":"Molly M.","family":"McNamee","sequence":"first","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, Northeast Georgia Health System, Gainesville, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Stolz","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, Northeast Georgia Health System, Gainesville, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Tyler","family":"Harvell","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, Northeast Georgia Health System, Gainesville, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Staley","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, Northeast Georgia Health System, Gainesville, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie E.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, Northeast Georgia Health System, Gainesville, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hedaya D.","family":"Othman","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, Northeast Georgia Health System, Gainesville, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian H.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, Northeast Georgia Health System, Gainesville, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,1]]},"reference":[{"key":"bibr1-00031348241241626","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08340-1"},{"key":"bibr2-00031348241241626","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-002-8917-4"},{"key":"bibr3-00031348241241626","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-08127-w"},{"key":"bibr4-00031348241241626","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.10.017"},{"key":"bibr5-00031348241241626","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2016.1212658"},{"key":"bibr6-00031348241241626","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2010.00953.x"},{"key":"bibr7-00031348241241626","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.8141"},{"key":"bibr8-00031348241241626","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2022.03.026"},{"key":"bibr9-00031348241241626","doi-asserted-by":"publisher","DOI":"10.1177\/0003134820949527"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241241626","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348241241626","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241241626","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:39:12Z","timestamp":1777379952000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348241241626"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,1]]},"references-count":9,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1177\/00031348241241626"],"URL":"https:\/\/doi.org\/10.1177\/00031348241241626","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,1]]}}}