[Therapy of bile duct calculi from the surgical viewpoint]

Stones in the ductus choledochus can be managed endoscopic-retrograde, percutaneously-transhepatic (in case it is impossible to reach the papilla vateri) or surgically. If choledocholithiasis is found on performing a laparoscopic cholecystectomy management nowadays consists of splitting the therapeutic regimen: Laparoscopic cholecystectomy and postoperative ERCP and papillotomy. A one time surgical procedure is certainly going to be more frequent in the future: laparoscopic cholecystectomy and revision of the choledochus. This procedure has great advantages for the patient as it needs just a single operation and is easy on his papilla. The necessary laparoscopic instruments have to be perfected and the procedure demands a substantial amount of time plus a high surgical standard.