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Endoscopic Procedures V: ERCP

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Updated: Jul 6, 2026

Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision

Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision

Published on: May 2, 2025

Laparoscopic common bile duct exploration.

Renam Tinoco¹, Augusto Tinoco, Luciana El-Kadre

¹Department of Surgery, São José do Avaí Hospital, Itaperuna, RJ, Brazil.

Annals of Surgery

|March 26, 2008

Summary

Laparoscopic common bile duct exploration (LCBDE) during gallbladder removal offers high success rates for clearing bile duct stones. This single-anesthesia approach is safe and effective for patients.

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Area of Science:

Minimally Invasive Surgery
Gastrointestinal Surgery
Biliary Tract Surgery

Background:

Laparoscopic common bile duct exploration (LCBDE) is a patient-preferred, single-anesthesia treatment for gallstones and common bile duct stones.
One-stage therapy via LCBDE demonstrates success rates comparable to sequential approaches, offering potential cost savings and establishing it as a standard of care.

Purpose of the Study:

To detail the technique of laparoscopic common bile duct exploration (LCBDE).
To report high stone clearance rates, and low morbidity and mortality associated with LCBDE.
To evaluate LCBDE as a single-stage treatment during laparoscopic cholecystectomy.

Main Methods:

A retrospective review of 5201 laparoscopic cholecystectomies performed between September 1991 and March 2007.
LCBDE was performed in 481 patients (9.25% of total cases).
Techniques included transcystic approach (46.78%) and choledochotomy (38.05%).

Main Results:

Successful laparoscopic stone clearance was achieved in 468 patients (97.3%).
The transcystic approach was used in 225 patients, and choledochotomy in 183 patients.
Thirteen patients (2.70%) required post-surgical endoscopic sphincterotomy, and seven had unexpected retained stones.

Conclusions:

LCBDE during laparoscopic cholecystectomy effectively addresses both gallbladder and common bile duct stones in a single procedure.
The technique demonstrates high success rates, low morbidity, and low mortality, supporting its successful application in clinical practice.