LAPAROSCOPIC CHOLECYSTECTOMY (LC), INTRAOPERATIVE ENDOSCOPIC SPHINCTEROTOMY (ES), AND COMMON BILE-DUCT STONES (CBDS) EXTRACTION FOR MANAGEMENT OF PATIENTS WITH CHOLECYSTOCHOLEDOCHOLITHIASIS

Background: A combined method of endoscopic sphincterotomy (ES) with c ommon bile duct stone (CBDS) extraction and laparoscopic cholecystecto my (LC) under general anesthesia for a single-session treatment of pat ients with colecysto-choledocholithiasis is described. Methods: From J une 1994 to January 1995, 15 consecutive cases considered for elective LC with preoperative diagnosis of CBDS underwent this procedure. Foll owing orotracheal intubation, the patient is turned on the left latera l decubitus for ES and CBDS extraction. Nasobiliary drainage is positi oned for per-laparoscopic cholangiogram. Routine LC is finally perform ed. Results: These two interventions were successfully accomplished in all patients, Mean duration of the operative time for the combined pr ocedure was 97.7 +/- 30.4 min, range 60-140 min, In four (26.6%) cases an accessory trocar with retracting instrument was used to obviate th e bowel distension. Conclusions: No complications of ES or LC were obs erved. Mean hospital stay was 3 days (range 2-5 days), Routine follow- up (mean 3 +/- 2 months, range 1-12 months) did not reveal biliary-rel ated problems in any of the observed patients.