CURRENT LAPAROSCOPIC APPROACHES TO PANCREATICOBILIARY DISEASE

Biliary-enteric anastomoses to duodenum or jejunum are a laparoscopic really and will find a place in the management of complicated choledoc holithiasis or malignant strictures of the bile duct. Staging by lapar oscopy in pancreatic malignancy is an ideal strategy, with some operat ors able to complete a definitive laparoscopic palliative bypass in th e same sitting. Intraoperative laparoscopic sonography is an advancing technique and has great potential in the evaluation of choledocholith iasis, hepatic metastases and staging of pancreatic cancer. Innovative options exist to deal with bile duct calculi, including antegrade sph incterotomy and intraoperative stent placement.