Recent Advances in the Treatment of Common Bile Duct Stones via Laparoscopic Common Bile Duct Incision and Stone Removal Following Failed ERCP
DOI:
https://doi.org/10.54097/ayzgrb49Keywords:
Common Bile Duct Stones, Endoscopic Retrograde Cholangiopancreatography, Laparoscopic Common Bile Duct Exploration, Common Bile Duct Exploration and Stone RemovalAbstract
Endoscopic retrograde cholangiopancreatography (ERCP) is the first-line minimally invasive treatment for common bile duct stones; however, stone removal fails in 5% to 25% of patients due to difficulties with catheterization, massive impacted stones, anatomical variations, and other factors. For patients following ERCP failure, laparoscopic common bile duct exploration and stone extraction (LCBDE) has garnered increasing attention in recent years as a salvage treatment. This article systematically reviews the relevant research literature on LCBDE following ERCP failure, covering the causes of ERCP failure, as well as the indications, technical key points, clinical outcomes, and predictive factors for success of LCBDE, with the aim of providing a reference for clinical decision-making regarding common bile duct stones.
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[1] Kim, H., Shin, S. P., Hwang, J. W., et al. (2020). Outcomes of laparoscopic common bile duct exploration after failed ERCP versus primary LCBDE for managing cholecystocholedocholithiasis. Journal of International Medical Research, 48(10), 300060520957560. https://doi.org/ 10. 1177/0300060520957560.
[2] Al-Ardah, M., Barnett, R. E., Whewell, H., Boyce, T., & Rasheed, A. (2023). Laparoscopic Common Bile Duct Clearance: Is It Feasible and Safe After Failed Endoscopic Retrograde Cholangiopancreatography? Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 33(1), 1-7. https://doi.org/10.1089/lap.2022.0372.
[3] Gupta, S., Aggarwal, A., Bansal, I., et al. (2025). Laparoscopic common bile duct exploration for managing difficult CBDS after failed ERCP. Journal of Minimally Access Surgery.
[4] Amaravadi, S., & Challagundla, N. N. (2025). A clinical, etiological, and outcome analysis of the surgical management of choledocholithiasis. Cureus, 17(9), e92099. https://doi. org/ 10. 7759/cureus.92099.
[5] Sanin, G., Cambronero, G., Patterson, J., et al. (2023). ERCP findings provide further justification for a “surgery-first” approach in choledocholithiasis. Surgical Endoscopy, 37(11), 8714–8719. https://doi.org/10.1007/s00464-023-10278-8.
[6] Navaratne, L., & Martinez Isla, A. (2021). Transductal versus transcystic laparoscopic common bile duct exploration: an institutional review of over four hundred cases. Surgical Endoscopy, 35(1), 437-448. https://doi.org/10.1007/s00464-020-07491-7.
[7] Ali, N., Nadeem, M., Nauyan, F., Mir, I., & Farooq, T. (2022). Laparoscopic Management of Common Bile Duct Stones: Stratifying Risks, a District Hospital Experience. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 32(2), 165-170. https://doi.org/10.1089/lap.2021.0393.
[8] Jones, T., Al Musawi, J., Navaratne, L., et al. (2019). Holmium laser lithotripsy improves the rate of successful transcystic LCBDE. Langenbeck's Archives of Surgery, 404(8), 985-992. https://doi.org/10.1007/s00423-019-01796-2.
[9] Yang, J. K., Hao, Z. D., Guo, W. L., et al. (2025). Simultaneous triple-endoscope combined with holmium laser treatment for gallbladder stones complicated by common bile duct stones: A prospective randomized controlled study. Chinese Journal of Minimally Invasive Surgery, 25(7), 398-404.
[10] Sardiwalla, I. I., Koto, M. Z., Kumar, N., et al. (2018). Laparoscopic common bile duct exploration using a rigid ureteroscope. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 28(10), 1169-1173. https:// doi. org/ 10.1089/lap.2018.0228.
[11] Zhang, K., Zhan, F., & Zhang, Y. (2016). Primary closure following laparoscopic common bile duct reexploration in patients with a history of biliary surgery. Indian Journal of Surgery, 78(5), 364-370.
[12] Gomez, D., Cabrera, L. F., & Villarreal, R. (2020). Laparoscopic common bile duct exploration with primary closure after failed ERCP. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 30(3), 267-272. https://doi.org/10.1089/lap.2019.0561.
[13] Bhardwaj, A. M., Trehan, K. K., & Sharma, V. (2022). Laparoscopic common bile duct exploration after failed ERCP. Journal of Minimally Access Surgery, 18(4), 533-538. https:// doi. org/10.4103/jmas.jmas_24_22.
[14] Di Mauro, D., Ricciardi, E., Siragusa, L., et al. (2019). Outcome of LCBDE after failed ERCP: a comparative study. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 29(11), 1391-1396. https://doi.org/10. 1089/ lap. 2019. 0247.
[15] Zhu, J., Zhang, Y., Du, P., et al. (2021). Systematic review and meta-analysis of LCBDE in patients with a history of failed ERCP. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 31(5), 654-662. https://doi.org/ 10.1097/ sle. 0000 000000001601.
[16] Younis, M., Pencovich, N., El-On, R., et al. (2022). Surgical treatment for choledocholithiasis following repeated failed ERCP. Journal of Gastrointestinal Surgery, 26(6), 1233-1240. https://doi.org/10.1007/s11605-022-05286-9.
[17] Anwar, M., Abdelmoneim, S. A., & Hamida, M. (2025). Efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management. BMC Surgery, 25(1), 325. https: // doi. org/10.1186/s12893-025-02912-1.
[18] Ma, D. M., & Gu, X. H. (2024). Comparison of Short-Term Outcomes and Safety Between Laparoscopic Common Bile Duct Exploration and Stone Removal and ERCP Combined with EST. Henan Journal of Surgery, 30(3), 15-17.
[19] Bansal, V. K., Krishna, A., & Rajan, K. (2016). Outcomes of LCBDE after failed ERCP in patients with gallstones and CBD stones. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 26(12), 985–991. https://doi.org/10. 1089/ lap. 2016.0412.
[20] Lee, S. J., Choi, I. S., & Moon, J. I. (2022). Optimal treatment for concomitant gallbladder stones and CBD stones. Surgical Endoscopy, 36(7), 4748–4756. https://doi.org/10.1007/ s00464-022-09320-6.
[21] Sirimanna, P., Suh, H., & Falk, G. L. (2024). Laparoscopic common bile duct exploration: what factors determine success? ANZ Journal of Surgery, 94(3), 375-379. https://doi. org/ 10. 1111/ ans.18832.
[22] Jenkins, V., Bird, D., & Houli, N. (2025). Transcystic laparoscopic common bile duct exploration: when to bail. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 35(3), e1374. https://doi.org/10.1097/sle.0000000000002743.
[23] Genet, D., Souche, R., & Roucaute, S. (2023). Upfront laparoscopic management of common bile duct stones: risk factors for failure. Journal of Gastrointestinal Surgery, 27(9), 1846-1854. https://doi.org/10.1007/s11605-023-05774-2.
[24] Navaratne, L., Martínez Cecilia, D., & Martínez Isla, A. (2021). The ABCdE score for predicting the need for lithotripsy assistance during transcystic LCBDE. Surgical Endoscopy, 35(11), 5971-5979. https://doi.org/10.1007/s00464-021-08349-1.
[25] Huang, Z. Z. (2025). A Comparison of the Efficacy of ERCP and LCBDE Combined with Holmium Laser Lithotripsy, Respected to LC, in the Treatment of Gallbladder Stones Complicated by Extrahepatic Bile Duct Stones. Journal of Rare and Rare Diseases, 32(3), 103-105.
[26] Zhang, S. Z., & Cheng, Y. (2025). The Impact of Laparoscopic Common Bile Duct Exploration on Perioperative Parameters and Complications in Patients with Recurrent Common Bile Duct Stones. Modern Diagnosis and Treatment, 36(5), 639–641, 647.
[27] Peng, Q., Wang, L., Duan, J. L., et al. (2025). Long-term Follow-up Results of Laparoscopic Common Bile Duct Exploration and Lithotripsy Combined with Cholecystectomy for Elderly Patients with Common Bile Duct Stones Complicated by Gallbladder Stones. Hebei Medicine, 31(11), 1840-1844.
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