Currently, the 2 most popular management options for patients undergoing laparoscopic cholecystectomy (LC) who are suspected of harboring common bile duct (CBD) stones are (1) preoperative endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) followed by LC during the same hospital admission, and (2) a single-stage laparoscopic management consisting of LC and laparoscopic CBD stone extraction either by the transcystic route or by laparoscopic common bile duct exploration.
1.CBD exploration in patients with gallstones and CBD stones is associated with increased operative time
- Cuschieri A.
- Lezoche E.
- Morino M.
- Croce E.
- Lacy A.
- Toouli J.
- et al.
EAES multicenter prospective randomized trial comparing two-stage vs single-stage management of patients with gallstone disease and ductal calculi.
Surg Endosc. 1999; 13: 952-957
2.and increased incidence of postoperative complications,
- Croce E.
- Golia M.
- Azzola M.
- Russo R.
- Crozzoli L.
- Olmi S.
- et al.
Laparoscopic choledochotomy with primary closure: follow-up (5-44 months) of 31 patients.
Surg Endosc. 1996; 10: 1064-1068
3.and it is not always successful.
- Fitzgibbons Jr., R.J.
- Gardner G.C.
Laparoscopic surgery and the common bile duct.
World J Surg. 2001; 25: 1317-1324
4.The potential failure of selective ERCP to clear CBD stones in patients with complex CBD stones indicates the necessity for another treatment option.
- Rhodes M.
- Sussman L.
- Cohen L.
- Lewis M.P.
Randomized trial of laparoscopic exploration of common bile duct versus postoperative endoscopic retrograde cholangiography for common bile duct stones.
Lancet. 1998; 351: 159-161
5.Here we report our initial experience with a 2-step laparoscopic-based technique involving LC with transcystic/transpapillary anterograde guidewire placement (TTAGP) followed by ERCP during the same hospital admission in 5 patients with complicated CBD stones in whom single or multiple attempts to perform preoperative ERCP had failed.
- Sharma S.K.
- Larson K.A.
- Adler Z.
- Goldfarb M.A.
Role of endoscopic retrograde cholangiopancreatography in the management of suspected choledocholithiasis.
Surg Endosc. 2003; 17: 868-871
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- EAES multicenter prospective randomized trial comparing two-stage vs single-stage management of patients with gallstone disease and ductal calculi.Surg Endosc. 1999; 13: 952-957
- Laparoscopic choledochotomy with primary closure: follow-up (5-44 months) of 31 patients.Surg Endosc. 1996; 10: 1064-1068
- Laparoscopic surgery and the common bile duct.World J Surg. 2001; 25: 1317-1324
- Randomized trial of laparoscopic exploration of common bile duct versus postoperative endoscopic retrograde cholangiography for common bile duct stones.Lancet. 1998; 351: 159-161
- Role of endoscopic retrograde cholangiopancreatography in the management of suspected choledocholithiasis.Surg Endosc. 2003; 17: 868-871
- Laparoscopic transcystic bile duct stenting in the management of common bile duct stones.Aust NZ J Surg. 2002; 72: 258-264
- A stratified intraoperative surgical strategy is mandatory during laparoscopic common bile duct exploration for common bile duct stones. Lessons and limits from an initial experience of 92 patients.Surg Endosc. 1997; 11: 722-728
- The rendezvous technique for the treatment of choledocholithiasis.Gastrointest Endosc. 2001; 54: 511-513
Accepted: July 17, 2004Athens, Greece
© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.