Safety and Efficacy of Single-Session Endoscopic Retrograde Cholangiopancreatography and Laparoscopic Cholecystectomy for the Treatment of Concomitant Gallbladder and Common Bile Duct Stones: A Single-Centre Experience

Abstract

Background and objectives Cholelithiasis is a commonly encountered biliary disorder in the Asian subcontinent, with a substantial burden observed in the Indian population. A significant proportion of patients admitted with gallbladder stones also present with choledocholithiasis. In individuals with acute calculous cholecystitis who are discharged without surgical intervention, the likelihood of subsequent gallstone-related complications increases progressively over time. The objective of the present study was to evaluate the safety, efficacy, and perioperative outcomes of performing single-session endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) in the same operative setting. This combined approach, although less commonly adopted than the traditional two-session strategy, may provide meaningful benefits in the management of patients with concomitant gallbladder and common bile duct (CBD) stones. Methods A retrospective single-centre review from a tertiary care centre in South India was conducted between June 2014 and June 2024. Patients with gallbladder pathology and concomitant choledocholithiasis were evaluated and scheduled for ERCP and LC in the same session. Results A total of 147 patients were included in the study, with a median age of 49 years and a female predominance. Choledocholithiasis with cholelithiasis was the most common indication in the study. The majority of cases were cannulated within 10 minutes (51%) and in five or fewer attempts (95.9%). Stone extraction was successful in 136 cases (92.5%), with CBD clearance achieved in 130 cases. Open CBD exploration was performed in three cases, and laparoscopic CBD exploration was performed in one case. LC was performed during the same session. Conclusion Under careful patient selection, single-session ERCP plus LC will not only save time but also avoid repeated administration of anaesthesia. Therefore, whenever expertise is available, the single-session ERCP and LC strategy can be adopted.