A national data analysis shows surgical bile duct exploration fell from 40% to under 9% of cases in 15 years, even though the single-stage approach meant a shorter hospital stay.

A 22-hospital analysis found single-stage bile duct surgery meant fewer procedures, lower charges, and a shorter stay — yet only 28% of patients received it.

A safety-net hospital comparison found one-stage LCBDE cut length of stay in half and saved roughly $14,000 per patient versus ERCP plus cholecystectomy — with no added risk if the exploration failed.

A standardized “surgery first” pathway raised duct clearance to 87% and cut hospital stay nearly in half — but surgeons still lack a dedicated antegrade stenting tool.

A network meta-analysis of 20 RCTs ranks LC + LCBDE first for lowest cost and shortest operative time — but its one weak spot is bile leak, the clearest target for the next generation of duct-closure tools.

A meta-analysis of 5 RCTs shows LCBDE and intraoperative ERCP clear the duct equally well — but LCBDE cuts pancreatitis fourfold, at the cost of more bile leaks and retained stones.

A meta-analysis of 16 studies (1,080 patients) finds internal biliary stents cut complications by more than half compared with T-tubes, while also shortening hospital stay and operative time.

A cohort of 49 antegrade transcystic stent attempts shows the technique nearly eliminates post-ERCP pancreatitis downstream and shortens hospital stay, with a learning curve of just 5-10 cases.

An editorial weighs the real costs of ERCP-first care (pancreatitis, cholangitis, sphincter damage) against transcystic exploration, which clears over 90% of ducts in one anesthetic without cutting the sphincter of Oddi.

This review is both manifesto and manual: with bile duct stones in 10-15% of cholecystectomies, evidence from over 8,000 patients favors single-stage transcystic management — and the barriers are training and workflow, not evidence.

A Medicare analysis of 516,372 cholecystectomies finds the surgery itself got safer over a decade — but ERCP use after it climbed 40%, pointing to the bile duct as surgery’s next quality frontier.

The 2024 JAMA Surgery review of gallstone pancreatitis management now states LCBDE has shorter hospital stays with no difference in efficacy or safety compared with ERCP — yet fewer than half of eligible patients get same-admission surgery.

Even nighttime and weekend cases can succeed with single-stage transcystic duct exploration, with shorter stays than the ERCP-based pathway.

A Swedish cohort of 9,593 gallstone pancreatitis patients shows ERCP without cholecystectomy leaves a 19.9% complication rate, versus 3.4% with same-admission surgery — yet only 28.7% get index-admission surgery nationwide.