Laparoscopic common duct exploration following failed endoscopic stone extraction

For patients with failed endoscopic extraction, further endoscopic, open, or laparoscopic clearance can be attempted. The following case report describes the laparoscopic removal of high common duct stones through a choledochotomy. As a nasobiliary stent was in place, a T-tube was considered unnecessary, and the choledochotomy was simply closed with a running suture. T-tubes are an irritant following laparoscopic duct exploration and in the future might be replaced, in selected cases, by a laparoscopically placed internal stent.