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Background It is not clear whether laparoscopic transcystic exploration (LTCE) laparoscopic choledochotomy (LCD) is superior in the management of choledocholithiasis. In this meta‐analysis, the success of LTCE versus LCD was evaluated. Methods Cochrane Central Register of Controlled Trials, Web of Science, Trip, PubMed, Ovid and Embase databases were searched systematically for relevant literature up to May 2017. Studies that compared the success rate of LTCE and LCD in patients with choledocholithiasis were included. PRISMA guidelines were followed. Multiple independent reviewers contributed on a cloud‐based platform. Random‐effects model was used to calculate odds ratios (ORs) or standardized mean differences (MDs) with 95 per cent confidence intervals. An a priori hypothesis was generated based on clinical experience that LTCE is as successful as LCD. Results Of 3533 screened articles, 25 studies comprising 4224 patients were included. LTCE achieved a lower duct clearance rate than LCD (OR 0.38, 95 per cent c.i. 0·24 to 0·59). It was associated with a shorter duration of surgery (MD −0·86, 95 per cent c.i. −0·97 to −0·77), lower bile leak (OR 0·46, 0·23 to 0·93) and shorter hospital stay (MD −0·78, −1·14 to −0·42) than LCD. There was no statistically significant difference in conversion, stricture formation or reintervention rate. Conclusion LCD has a higher rate of successful duct clearance, but is associated with a longer duration of surgery and hospital stay, and a higher bile leak rate.

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The authors describe a project that compared the effects of three interventions on the retirement investment knowledge of public school teachers in the Midwest. They interpret outcomes from three different interventions (online training, site-based workshop, and hybrid of online and site-based). While the study results indicate that program participants increased their investment and retirement knowledge of content presented in the measured approaches, the differences in gains between the interventions were not significant. The authors call for additional research into the investment and retirement education of teachers that employs larger samples and uses valid and reliable instrumentation.

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Little attention has been paid to the practical implications of implementing a unit record system on a community college campus. Potential benefits include the ability to capture student success and track outcomes for external compliance and internal planning efforts, but potential issues could impact the ability of a community college to manage the implementation of a system, including privacy, security, dealing with students who opt out, integration with current systems, data verification, and agency coordination. This chapter addresses the challenges and opportunities of implementing a unit record system on campus by addressing potential costs, benefits, and integration with already existing data and accountability processes.

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