Laparoscopic common bile duct exploration and hand sutured closure of the choledochotomy

In the years since 1987, when Mouret introduced laparoscopic cholecystectomy in France, this approach has become the preferred method for management of symptomatic gallbladder disease. However, the treatment of calculous disease other than the gallbladder is not generally practiced by the laparoscopic approach. The treatment of common duct stones is largely managed by preoperative Endoscopic Retrograde Cholangio Pancreatography (ERCP) or choledochotomy and exploration through a laparotomy incision. The authors believe that this lack of acceptance of laparoscopic treatment of common duct stones is because of the ready availability of ERCP and sphincterotomy in most centers countenanced by the difficulty of laparoscopic treatment.