Laparoscopic common duct exploration in the management of choledocholithiasis

BACKGROUND: Optimal treatment strategies for addressing common duct stones at laparoscopic cholecystectomy remain controversial. The study presents th e authors' experience with laparoscopic common bile duct exploration (LCBDE ). METHODS: A retrospective review was performed of 71 LCBDEs performed over 5 years using either transcystic duct flushing and mechanical techniques, tr anscystic duct basket retreival techniques, or laparoscopic choledochotomy. RESULTS: Laparoscopic CEDE resulted in ductal clearance in 61 of 71 (85%) c ases with only 1 case of unsuspected retained common duct stones and only 1 major complication. Review of the cases that did not result in common duct clearance suggests that the success rate of laparoscopic CEDE could be inc reased. CONCLUSIONS: Laparoscopic CEDE is an effective treatment for concurrent gal lstones and common duct stones and avoids the potential morbidity of an end oscopic sphincterotomy. General surgeons with adequate training and experie nce can perform laparoscopic CEDE safely and effectively. (C) 2000 by Excer pta Medica, Inc.