Laparoscopic and endoscopic management of common bile duct stones.

ABSTRACT

The rapid evolution and acceptance of laparoscopic cholecystectomy for the management of symptomatic cholelithiasis and acute and chronic cholecystitis are unprecedented in modern surgical practice. With rapid advances in laparoscopic and endoscopic instrumentation and surgical skills, many surgeons are developing minimally invasive techniques and strategies for treating the patient with known, suspected, or unsuspected choledocholithiasis. Recent articles describing the current status, complications, results, and future directions of laparoscopic and endoscopic management of common bile duct stones are reviewed. The role of endoscopic retrograde cholangiopancreatography and sphincterotomy, laparoscopic exploration of the common bile duct, choledochoscopy, and percutaneous transhepatic extraction techniques are discussed.