TTP5.11 Laparoscopic Transcystic spyglass-assisted CBD exploration and clearance: Is it an Efficient and Cost-effective alternative for CBDS disease?

Aim To evaluate the safety and efficacy of Laparoscopic Transcystic Spyglass Exploration, performed alongside Laparoscopic Cholecystectomy, as a one-stage procedure for patients with proven or suspected common bile duct (CBD) stones. Methods A retrospective cohort study conducted at a District General Hospital (DGH) from January 2023 to July 2024 included thirty-one patients undergoing Laparoscopic Spyglass-assisted CBD exploration alongside Laparoscopic Cholecystectomy and patients who had the standard two sessions (ERCP + LC) by a single surgeon. Results The study included 38 patients, (G1) 21 (45%) patients had CBDE + Spyglass, and out of them 5 (A) patients needed interventions (3 mechanical lithotripsy + 2 laser lithotripsy), and 9 patients (B) without interventions. G2 (17, 55%) had two sessions (ERCP + LC) *Operative Time and Success Rates: G1: A the mean operative time was 117 minutes. B, the mean operative time increased to 175 minutes. The success rate for CBD clearance was 100%, as confirmed by post-procedure OTC. G2: the mean operative time was 131 minutes (ERCP + LC) with a success rate of 89% as two patients had to repeat the ERCP. *Length of Stay and Complications:** G1: A (mean LOS: 0.57 days). B had a mean LOS of 1.25 days. No complications were reported. G2: mean LOS 1.52 days (ERCP + LC). *Cost Comparison: the Spyglass-assisted procedure was more cost-effective, largely due to the reduced hospital stay and avoidance of multiple admissions for ERCP and laparoscopic cholecystectomy. Conclusion Laparoscopic Transcystic CBDE with the assistance of Spyglass is effective, safe, and cost-effective in skilled hands.