COMMON BILE-DUCT CALCULI AT LAPAROSCOPIC CHOLECYSTECTOMY - A TECHNIQUE FOR MANAGEMENT

Laparoscopic cholecystectomy was attempted in 150 unselected patients. The use of routine intraoperative cholangiography prevented serious b ile duct injury in one patient. It also showed 75% of patients suspect ed pre-operatively of having common duct stones, had passed them by th e time of cholecystectomy. Eight of 12 diagnosed duct stones (5 suspec ted, 7 unsuspected) were removed laparoscopically. A technique is desc ribed using inexpensive and readily available equipment that allows th e transcystic duct treatment of the majority of common duct stones. Th e development and use of such techniques to laparoscopically treat duc t stones will once more allow surgeons to treat all biliary calculi at the one procedure and reduce unnecessary dependence on endoscopic ret rograde cholangiopancreatography/sphincterotomy.