| [ Summary ] |
Recently, endoscopic sphincterotomy (EST) has become the standard treatment for choledocholithiasis, because of its convenience and lack of invasiveness. However, it is difficult to perform EST in cases such as those with Lemmel's syndrome. Additionally there is still a controversy as to whether the function of the sphincter is maintained after EST and what the long-term results of EST are. Thus, surgical procedures for choledocholithiasis are still necessary. After the introduction of laparoscopic cholecystectomy, T-tube insertion in to the common bile duct is less common, because of its longer admission period, compared to other treatments. Choledochoduodenostomy is in dicated for cases of primary common bile duct stones, however there is a risk of causing gastrointestinal cancer from gastroesophageal regurgitation of bile juice. A simple closure of the common bile duct with biliary drainage by ENBD or C-tube, which now can be done laparoscopically, is most common in cases contra-indicated for EST, and are expected to be used to preserve sphincter function and because of shorter admission times than those needed for EST followed by laparoscopic cholecystectomy. |