Laparoscopic suture technique after common bile duct exploration

Performing both laparoscopic cholecystectomy and choledocholithotomy during the same operative procedure for both suspected and unsuspected stones is an attractive alternative to preoperative endoscopic retrograde cholangiopancreatography and stone removal or to conversion of the laparoscopic procedure to open common duct exploration. During laparoscopic exploration, intracorporeal suture and knot-tying may be tedious. We thus developed a technique of suture of the choledochus that avoids the use of knots and avoids placing metal clips in contact with the common bile duct. This technique was accurate, fast, and easily controlled in eight of 21 patients, and no major complications or mortality occurred.