{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T19:41:28Z","timestamp":1785008488010,"version":"3.55.0"},"reference-count":6,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"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":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There has been a shift in the management of choledocholithiasis from laparoscopic common bile duct exploration to endoscopic retrograde cholangiopancreatography. This has led to an increase in hospital length of stay, costs, and specifically for rural hospitals, transfer to a tertiary center for ERCP. Given this shift of choledocholithiasis management to advanced GI endoscopists, general surgery residents are rarely performing laparoscopic transcystic common bile duct explorations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study of 69 consecutive laparoscopic transcystic common bile duct explorations (LCBDE) performed by 2 general surgeons in a rural community over 5\u00a0years between 2017 and 2022. Primary outcomes included successful duct cannulation, successful stone clearance, instruments used, operative time, and significant complications (pancreatitis, bile leak, bleeding, bile duct injury). Specific technique for laparoscopic transcystic common bile duct exploration is outlined in Appendix 1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was a median age of 54\u00a0years (Range 17-91). There was successful cannulation in 97% and successful stone clearance in 82% of cases. In the vast majority of cases only a guide wire and biliary balloon dilation catheter were utilized to perform the procedure. Median operative time for laparoscopic cholecystectomy with cholangiogram was 40\u00a0minutes. Median operative time for laparoscopic cholecystectomy with cholangiogram and transcystic common bile duct explorations was 64\u00a0minutes (Range 39-168). Therefore, the median time added by performing LCBDE was 24\u00a0minutes There were no complications during laparoscopic transcystic common bile duct explorations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Laparoscopic transcystic common bile duct exploration can be safely, efficiently, and successfully performed with 0.035-inch Roadrunner PC guidewire, TAUT intraducer and an Advance Biliary Balloon Catheter. In order to shift the management of choledocholithiasis back to the general surgeon to decrease the length of stay and cost, there needs to be a change at the residency training level.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251376688","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T08:20:41Z","timestamp":1756974041000},"page":"2035-2038","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Laparoscopic Common Bile Duct Exploration in a Rural Community"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2080-4837","authenticated-orcid":false,"given":"Rebekah","family":"Wever","sequence":"first","affiliation":[{"name":"Sanford University of South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Foerster","sequence":"additional","affiliation":[{"name":"University of South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"O\u2019Hanlon","sequence":"additional","affiliation":[{"name":"Ohio Health Southeastern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sarap","sequence":"additional","affiliation":[{"name":"Ohio Health Southeastern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.8141"},{"key":"e_1_3_3_3_2","first-page":"CD003327","article-title":"Surgical versus endoscopic treatment of bile duct stones","volume":"12","author":"Dasari BV","year":"2013","unstructured":"Dasari BV, Tan CJ, Gurusamy KS, et al. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev. 2013;12:CD003327.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.1228"},{"key":"e_1_3_3_5_2","volume-title":"Common Bile Duct Exploration in Decline: Majority of These Procedures are Done in Non-teaching Hospitals in the US","author":"Jacob S","year":"2010","unstructured":"Jacob S, Rudnicki M. Common Bile Duct Exploration in Decline: Majority of These Procedures are Done in Non-teaching Hospitals in the US. Washington, DC: National Harbor; 2010."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2005.04.029"},{"key":"e_1_3_3_7_2","unstructured":"Accreditation Council for Graduate Medical Education. Residency review committee for surgery. Defined category minimum numbers for general surgery. https:\/\/www.acgme.org\/"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251376688","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251376688","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251376688","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:26Z","timestamp":1777379906000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251376688"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,4]]},"references-count":6,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/00031348251376688"],"URL":"https:\/\/doi.org\/10.1177\/00031348251376688","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,4]]}}}