Several techniques of laparoscopic bile duct exploration and intraoperative endoscopic sphincterotomy (ES) have been developed to treat patients with common bile duct (CBD) stones in one session and avoid the complications of ES. With all these options available, very few randomized controlled trials (RCTs) have been undertaken. This review analyzes those studies.
MethodsWe searched PubMed. Four RCTs and a Cochran Database Systematic Review were found.
ResultsTwo RCTs compared preoperative ES and laparoscopic CBD exploration (E) for known CBD stones. Laparoscopic CBDE had shorter length of hospitalization. Two RCTs compared immediate and delayed treatment and found that length of stay was less with laparoscopic CBDE, but clearance rates and morbidity/mortality were similar.
ConclusionsStudies suggest that CBD stones discovered at the time of cholecystectomy are best treated during the same operation. The transcystic approach is safest if applicable. Individual surgeons must be aware of their own capabilities and those of the available endoscopists and perform the safest technique.
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Department of Surgery, Cedars-Sinai Medical Center, 8635 W. Third St., Suite 795W, Los Angeles, CA, 90048, USA
Edward H. Phillips
Department of Surgery, Flinders University, Adelaide, Australia
James Toouli
Department of Surgery, Indiana University, Indianapolis, IN, USA
Henry A. Pitt
Department of Surgery, Northwestern University, Chicago, IL, USA
Nathaniel J. Soper
Correspondence to Edward H. Phillips.
About this article Cite this articlePhillips, E.H., Toouli, J., Pitt, H.A. et al. Treatment of Common Bile Duct Stones Discovered during Cholecystectomy. J Gastrointest Surg 12, 624–628 (2008). https://doi.org/10.1007/s11605-007-0452-0
Received: 17 September 2007
Accepted: 28 November 2007
Published: 05 January 2008
Issue Date: April 2008
DOI: https://doi.org/10.1007/s11605-007-0452-0
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