[Minimally invasive surgery--choledocholithiasis: therapeutic splitting]

Patients with cholecysto- and choledocholithiasis may benefit from the advantages of laparoscopic cholecystectomy by intraoperative common bile duct exploration or preoperative endoscopic papillotomy (EPT) with stone removal. We performed therapeutic splitting in 94 patients. Morbidity was 4.2% and mortality was zero. A follow up study of 50 patients shows residual stones in 2% and papillary stenosis in 2%. We believe our results, supported by data on EPT in the literature, show that two-stage endoscopic stone removal prior to laparoscopic cholecystectomy is a safe and effective method for treating cholecystolithiasis combined with choledocholithiasis.