Management of common bile duct stones |
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Authors: | Eric S Hungness MD Nathaniel J Soper MD |
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Institution: | (1) Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois;(2) Northwestern University, Galter 10–105, 201 E. Huron St., 60611 Chicago, IL |
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Abstract: | Conclusions Choledocholithiasis remains a complicated and challenging disease process for today’s clinicians. Transabdominal ultrasound
and ERC are the most common preoperative imaging modalities with endoscopic ultrasound, MRCP, and HCT emerging as potentially
more accurate and less invasive tools. Intraoperatively, LUS and IOC are complimentary in detecting CBD stones, while laparoscopic
CBDE is commonly and safely performed by surgeons comfortable with advanced laparoscopic techniques. Postoperative ERC is
effective with failure of laparoscopic CBDE, surgeon inexperience, and unfavorable anatomy and patient selection. Open CBDE
should never be looked upon as a failure, while sphincterotomy, sphincteroplasty, and choledochoenterostomy remain necessary
operations for certain patients. The proposed algorithm is only a guideline, and ultimate treatment depends on physician experience
and available resources. |
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Keywords: | |
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