LAPAROSCOPIC CHOLECYSTECTOMY AND ENDOSCOPIC SPHINCTEROTOMY UNDER A SINGLE ANESTHETIC - A CASE-REPORT

Several options have been described for the management of unsuspected common bile duct stones diagnosed for the first time by transcystic ch olangiography during laparoscopic surgery. These include immediate con version to open laparotomy and formal common bile duct exploration, la paroscopic bile duct exploration, or postoperative biliary endoscopy ( i.e., ERCP with sphincterotomy and stone extraction). Herein we descri be a fourth option which allows the surgeon to manage both cholelithia sis and choledocholithiasis at the time of laparoscopic intervention: endoscopic sphincterotomy performed immediately after laparoscopic cho lecystectomy under one anesthetic. This option seems the most logical when the surgeon wishes to preserve the minimally invasive approach.