ENDOSCOPIC SPHINCTEROTOMY PRIOR TO LAPAROSCOPIC CHOLECYSTECTOMY FOR THE TREATMENT OF CHOLELITHIASIS

Background/Aims: Laparoscopic cholecystectomy is the standard treatmen t for symptomatic cholecystolithiasis; however, there is debate on the management of patients with concomitant common bile duct stones. Seve ral options have been suggested; endoscopic sphincterotomy and laparos copic common bile duct exploration seemed to be the preferred methods at this moment. Materials and Methods: We performed endoscopic sphinct erotomy prior to laparoscopic cholecystectomy in 51 cases of acute sym ptomatic cholelithiasis. Results: Endoscopic retrograde cholangiopancr eatography and endoscopic sphincterotomy procedure-related complicatio n, rate was 5.4%, including 1 pancreatitis, 1 cholangitis, and 2 major bleeds. After follow up period of 15-42 months, recurrent stones were found in. 2 patients. Conclusion: Endoscopic sphincterotomy combined with laparoscopic cholecystectomy is a safe and effective therapy for symptomatic cholecystolithiasis with concomitant choledocholithiasis. Recurrent stones did occur, but further studies are needed to compare the incidence of recurrent stones after endoscopic sphincterotomy and after laparoscopic common bile duct exploration.