{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:47:29Z","timestamp":1793393249992,"version":"4.5.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This meta-analysis aims to assess the safety and efficacy of single-stage and two-stage ERCP combined with laparoscopic cholecystectomy in the management of bile duct stones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search was conducted in PubMed, Embase, Cochrane Library, and Web of Science databases to identify prospective randomized controlled studies comparing the effectiveness of single-stage ERCP combined with laparoscopy, also known as Laparoscopic-Endoscopic Rendezvous (LERV), and the sequential two-step approach of ERCP followed by laparoscopic cholecystectomy (ERCP+LC). Stone clearance success rate, incidence of complications, occurrence of pancreatitis, and hyperamylasemia were analyzed using Stata software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine studies involving a total of 1,003 participants were included in the analysis, with 505 patients undergoing sequential surgery and 498 patients receiving LERV treatment. The LERV group exhibited a significantly higher stone clearance rate compared to the sequential surgery group (RR\u202f=\u202f0.62, 95% CI: 0.49\u20130.79). The incidence of pancreatitis was significantly higher in the sequential surgery group compared to LERV (RR\u202f=\u202f1.90, 95% CI: 1.61\u20132.24). Similarly, the occurrence of hyperamylasemia was significantly higher in the sequential surgery group compared to LERV (RR\u202f=\u202f1.93, 95% CI: 1.55\u20132.40).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings of this meta-analysis support the effectiveness of LERV as a treatment option for bile duct stones. LERV demonstrates superior outcomes compared to the sequential two-step approach of ERCP followed by laparoscopic cholecystectomy (ERCP+LC). Specifically, LERV shows improved stone clearance success rates and a decreased incidence of pancreatitis. These results suggest that LERV is a safe and efficient procedure for the management of bile duct stones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      2025100075,\n                      <jats:uri>https:\/\/doi.org\/10.37766\/inplasy2025.10.0075<\/jats:uri>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1713857","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T06:31:00Z","timestamp":1764225060000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Safety and efficacy comparison of single-stage and two-stage ERCP combined with laparoscopic cholecystectomy: a meta-analysis and systematic review"],"prefix":"10.3389","volume":"12","author":[{"given":"Jian-Xiong","family":"Tai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingxiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.surg.2020.07.050","article-title":"Hyperamylasemia and acute pancreatitis after pancreatoduodenectomy: two different entities","volume":"169","author":"Loos","year":"2021","journal-title":"Surgery"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"148","DOI":"10.3238\/arztebl.2020.0148","article-title":"The treatment of gallstone disease","volume":"117","author":"Gutt","year":"2020","journal-title":"Dtsch Arztebl 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