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Choledocholithiasis: evolving intraoperative strategies.

J L Ponsky1, B T Heniford, K Gersin

  • 1Department of General Surgery, Center for Minimally Invasive Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA.

The American Surgeon
|April 12, 2000
PubMed
Summary
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Laparoscopic surgery for common bile duct stones has evolved significantly. This article reviews current techniques for laparoscopic common bile duct stone management, including transcystic extraction and direct choledocholithotomy.

Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Historically, open surgery and endoscopic techniques managed common bile duct stones.
  • Laparoscopic cholecystectomy presented challenges for common bile duct stone removal.

Purpose of the Study:

  • To define the current role of various laparoscopic methods for treating common bile duct stones.

Main Methods:

  • Review of evolving laparoscopic techniques for common bile duct stone extraction.
  • Comparison of transcystic extraction, laparoscopic choledocholithotomy, and intraoperative ERCP.

Main Results:

  • Laparoscopic techniques for common bile duct stones have become sophisticated.
  • Preoperative ERCP is not always necessary.

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Conclusions:

  • Various laparoscopic approaches exist for common bile duct stones.
  • The optimal method depends on clinical context and surgeon expertise.