One-Stage versus Two-Stage ERCP followed by laparoscopic cholecystectomy for the Management of Pediatric Choledocholithiasis: A Systematic Review and Meta-Analysis

jpedsurg.org

The optimal approach to managing pediatric choledocholithiasis remains a subject of ongoing debate. Both single-stage strategies, combining laparoscopic cholecystectomy (LC) with bile duct clearance via intraoperative ERCP and sphincterotomy, and two-stage approaches, typically involving preoperative ERCP followed by interval LC, are widely employed. While prior meta-analyses in predominantly adult populations suggest comparable safety profiles between these strategies, pediatric-specific data remain lacking in consensus.

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Article · Nov 2025 · 1 min read

In brief

This systematic review compares single-stage (combined laparoscopic cholecystectomy with intraoperative ERCP) versus two-stage (preoperative ERCP followed by interval cholecystectomy) approaches for treating bile duct stones in pediatric patients. The analysis addresses a gap in pediatric-specific evidence regarding optimal surgical timing and technique for choledocholithiasis management.

Single-stage LC with intraoperative ERCP and two-stage preoperative ERCP followed by LC are both used for pediatric choledocholithiasis.
Adult meta-analyses show comparable safety between approaches, but pediatric-specific evidence remains limited.
Optimal management strategy for pediatric choledocholithiasis is still debated due to lack of consensus data.

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