Single-Incision Laparoscopic Common Bile Duct Exploration and Cholecystectomy: An Innovative Transcystic Technique

Yidao Chua; Olivia Jiajing Guo; Stephen Chang

doi:10.33165/rmj.2026.e271640

Authors

Yidao Chua Otago Medical School, University of Otago, Dunedin, New Zealand https://orcid.org/0009-0000-8568-6483
Olivia Jiajing Guo Surgery Department, Research Unit, GLAD Clinic, Singapore https://orcid.org/0009-0006-8892-2537
Stephen Chang Surgery Department, Research Unit, GLAD Clinic, Singapore / Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore https://orcid.org/0009-0007-0063-3632

DOI:

https://doi.org/10.33165/rmj.2026.e271640

Keywords:

Stones, Choledocholithiasis, Bile duct, Single-incision, Transcystic

Abstract

Background: Common bile duct stones may be managed via 2-stage endoscopic retrograde cholangiopancreatography followed by single-incision laparoscopic cholecystectomy, or 1-stage laparoscopic common bile duct exploration and cholecystectomy (LCBDE+LC). This study reports early experience and technique in 1-stage single-incision laparoscopic common bile duct exploration and cholecystectomy (SILCBDE+SILC).

Case Presentation: This study analyzed 10 consecutive cases of choledocholithiasis that underwent SILCBDE+SILC from April 2022 to December 2023. The surgical technique involved the innovative use of an Endoscopic Applicator to better stabilize the choledochoscope for cystic duct cannulation. The mean (SD) operative time was 99 (34) minutes. All patients had 100% stone clearance rate and cholecystectomies with no complications. No conversion to multiport or open surgery was noted. Mean postoperative hospital stay was 1.5 days. Postoperative morbidity and mortality were 0%.

Conclusions: 1-stage SILCBDE+SILC is safe. This study’s technique involving the use of an Endoscopic Applicator addresses the difficulties of manipulating the choledochoscope for cystic duct cannulation, despite its flexible nature and the extra distance between its entry port-site and the cystic ductotomy.

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