This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Johnson, A. B. Articles by Hunter, J. G. Search for Related Content PubMed Articles by Johnson, A. B. Articles by Hunter, J. G. Social Bookmarking                         What's this?

Future Treatment of Common Bile Duct Stones

Department of Surgery, Emory University School of Medicine, Atlanta, GA

John G. Hunter, MD

Department of Surgery, Emory University School of Medicine, Atlanta, GA

Management options for patients found to have common bile duct stones have expanded as a function of improved instrumentation and radiographic support. Technological advances initially lead to increased costs but eventually result in improved quality for patients. Controversy exists for patients with either soft clinical findings or stones found at the time of laparoscopic cholecystectomy. As laparoscopic common duct exploration becomes more widespread the need for perioperative ERCP will likely decrease; however, this will depend on the experience of the surgeons at a given institution. Common bile duct stones found at the time of laparoscopic cholecystectomy can be approached in a variety of different ways. The most commonly used methods are laparoscopic transcystic common bile duct exploration, laparoscopic choledochotomy with common bile duct exploration, open common bile duct exploration, laparoscopic antegrade sphincterotomy, and postoperative ERCP. In the future, the treatment goal of biliary lithiasis will be to accomplish cholecystectomy and removal of bile duct stones in a single stage. Advances in fiberoptic technology will make transcystic duct exploration more effective, but it is likely that sphincterotomy (antegrade or retrograde) will be used preferentially for the distally impacted stone.

Key Words: Laparoscopic • choledochotomy • transcystic common bile duct exploration • common bile duct stones • endoscopic retrograde cholangiopancreatography • antegrade or retrograde sphincterotomy.

Surgical Innovation, Vol. 4, No. 1, 45-47 (1997)
DOI: 10.1177/155335069700400108


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?