Since the introduction of laparoscopic cholecystectomy, the management of common bile duct (CBD) stones has undergone significant change. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is now routinely done in cases where the diagnosis of choledocholithiasis is suspected preoperatively, with clearance of the bile ducts before laparoscopic cholecystectomy. Intraoperative discovery of CBD stones by cholangiography represents a challenge to the surgeon, who must make a decision about when to perform laparoscopic CBD exploration, convert to open surgery, or send the patient for ERCP during the postoperative period. Because ERCP has a definite failure rate, laparoscopic CBD exploration can be a treatment option. Among 2500 laparoscopic cholecystectomies done by our group from January 1991 to June 1997, 50 patients (2%) underwent laparoscopic CBD exploration, 13 by the transcystic technique and 37 by choledocotomy, with a conversion rate of 8% and a hospital stay of 4.3 days. One patient died from complicated pancreatitis following ERCP and unsuccessful extraction of a CBD stone. We obtained our goal of a CBD free of stones in 92% of the cases. We conclude that laparoscopic CBD exploration is an effective method for treating choledocolithiasis that allows management of this pathology in one stage, although it requires advanced laparoscopic skills and adequate equipment.
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Similar content being viewed by others Explore related subjectsDiscover the latest articles and news from researchers in related subjects, suggested using machine learning. Author information Authors and AffiliationsDepartment of Surgery, Hospital Regional 1° de Octubre, ISSSTE, Instituto Politecnico Nacional 1669, Magdalena de las Salinas, Mexico City, D.F., 52760, Mexico, , , , , , MX
Samuel Shuchleib
“Karl Storz” Center for Endoscopic Surgery, ABC Hospital, Sur 136 No. 115 Col. Americas, Mexico City, D.F., 01120, Mexico, , , , , , MX
Alberto Chousleb
Department of Surgery, Hospital Regional 1° de Octubre, ISSSTE, Instituto Politecnico Nacional 1669, Magdalena de las Salinas, Mexico City, D.F., C.P. 07300, Mexico, , , , , , MX
Alejandro Mondragon, Eduardo Torices & Antonio Licona
Department of Surgery, ABC Hospital, Sur 136 No. 115 Col. Americas, Mexico City, D.F., 01120, Mexico, , , , , , MX
Jorge Cervantes
Shuchleib, S., Chousleb, A., Mondragon, A. et al. Laparoscopic Common Bile Duct Exploration. World J. Surg. 23, 698–702 (1999). https://doi.org/10.1007/PL00012371
Issue Date: July 1999
DOI: https://doi.org/10.1007/PL00012371
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