Related Experiment Video
Updated: Aug 12, 2026
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Sequential intraluminal endoscopic and laparoscopic treatment for bile duct stones associated with gallstones
G Zaninotto1, M Costantini, M Rossi
1Department of Surgery, University of Padova School of Medicine, Istituto di Chirurgia Generale 2.
Background:
On the basis of a flowchart including prior or current jaundice or pancreatitis, abnormal liver function, ultrasound or IV cholangiography, bile duct (BD) stones were suspected in 71/593 patients referred for gallstones.
Methods:
When endoscopic retrograde cholangiography detected BD stones, endoscopic sphincterotomy (ES) and endoscopic BD clearance were attempted, followed by laparoscopic cholecystectomy (LC). BD stones were found in 44/71 patients. The sensitivity values of preoperative conditions were: 92% for IV cholangiography, 88% for abnormal liver function, 50% for ultrasound, and 37% for jaundice at admission.
Results:
Endoscopic clearance succeeded in 37 patients and LC was completed in 33 patients. Conversion to open surgery (9%) was comparable with the rate in patients without BD stones. The median hospital stay for the sequential endoscopic and laparoscopic treatments was 13 days (range 4-54) or 22 days if open surgery was used.
Conclusions:
In conclusion, BD stones can be endoscopically cleared preoperatively in most patients without interfering with LC.
