[Endoscopic surgery for management of cholecystolithiasis and choledocholithiasis: basic and clinical aspects]

At present, laparoscopic surgery is considered to be the method of first choice for the management of cholecystolithiasis or choledocholithiasis. The clinical advantages and problems inherent to endoscopic surgery for the management of cholecystolithiasis or choledocholithiasis described in the literature are summarized and their reasons are discussed in this paper. Moreover, methods overcome the problems of endoscopic surgery are discussed. Among the problems inherent to laparoscopic surgery, the prevention of perioperative and postoperative complications has reserved serious attention of surgeons because surgery is carried out using mismatched instruments in a two-dimensional field monitored on a TV screen. However, the main causes of complications are attributable to the immature techniques of surgeons. Therefore, an increase in the number of educated surgeons is strongly awaited. To solve the problems mentioned above, better training in endoscopic surgery should be included in postgraduate surgical educational programs.