TY - JOUR T1 - Intraoperative on-table endoscopic retrograde cholangiopancreatography (ERCP) is better than laparoscopic bile duct exploration for concomitant bile duct stones during emergency laparoscopic cholecystectomy JF - Evidence Based Medicine JO - Evid Based Med SP - 27 LP - 27 DO - 10.1136/ebmed-2016-110549 VL - 22 IS - 1 AU - Pramod Kumar Garg AU - Virinder Kumar Bansal Y1 - 2017/03/01 UR - http://ebm.bmj.com/content/22/1/27.abstract N2 - Commentary on: Poh BR, Ho SP, Sritharan M, et al. Randomized clinical trial of intraoperative endoscopic retrograde cholangiopancreatography versus laparoscopic bile duct exploration in patients with choledocholithiasis. Br J Surg 2016;103:1117–24OpenUrl.Some 15% of patients with gallbladder (GB) stones have concomitant stones in the bile duct (BD) believed to have migrated out from the GB. While asymptomatic GB stones may be managed expectantly, BD stones, if detected, require removal even if asymptomatic because of their potential to cause two major complications: acute cholangitis and acute pancreatitis. In patients with concomitant GB and BD stones, open surgery was standard approach but was associated with wound morbidity and T-tube-related problems. With the advent of endoscopic retrograde cholangiopancreatography (ERCP) in the 1970s, endoscopic removal of BD stones gradually received wide acceptance.1 With the … ER -