What is the role of laparoscopic cholecystectomy in the treatment of choledocholithiasis?

Updated: Apr 16, 2020
  • Author: Danny A Sherwinter, MD; Chief Editor: Kurt E Roberts, MD  more...
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Answer

The following treatment options are available for patients found to have choledocholithiasis:

  • Preoperative ERCP with sphincterotomy
  • Postoperative ERCP with sphincterotomy
  • Laparoscopic IOC with laparoscopic common bile duct (CBD) exploration
  • Open CBD exploration and T-tube placement

In a patient with documented choledocholithiasis, a single laparoscopic procedure that treats both cholelithiasis and choledocholithiasis in a single setting is preferable. This approach appears to be cost-effective and to be associated with a shorter hospital stay than a two-stage procedure (eg, preoperative ERCP with sphincterotomy followed by laparoscopic cholecystectomy) would be. In experienced hands, laparoscopic CBD exploration appears to have high success rates (75-91%). The exact algorithm followed depends on local expertise.


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