| Theme |
Treatment of Choledocholithiasis |
| Title |
Surgical Management of Bile Duct Stones |
| Author |
Kazunori Shibao |
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health |
| Author |
Toshihisa Tamura |
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health |
| Author |
Takehide Tajima |
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health |
| Author |
Norihiro Sato |
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health |
| Author |
Keiji Hirata |
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health |
| [ Summary ] |
The most common interventional options for patients with concomitant common bile duct stones (CBDS) and gallstones include : 1) two‒stage approach combining laparoscopic choledochotomy with preoperative or postoperative endoscopic retrograde cholangiography, 2) single‒stage laparoscopic procedure with laparoscopic or laparotomic stone extraction. There is no significant difference in the mortality, morbidity, retained stones, and failure rates between the single‒stage laparoscopic procedure and two‒stage endoscopic approaches. Although both techniques are effective in managing choledocholithiasis, the suitable therapy depends on the conditions such as number and size of stones, the surgeon's experience, and patient's satisfaction. Laparoscopic common bile duct exploration is an ideal surgical management to preserve papillary function by applying small abdominal incision. Furthermore, this presents significantly lower cost to patients and the health care system. However, it remains challenging because of the technical difficulties. We herein review the different techniques of treating common bile duct stones with the special focus on various surgical modalities. |