Laparoendoscopic approaches to common bile duct stones.

Since the advent of laparoscopic cholecystectomy, there has been a debate regarding the most effective approach to intraoperative management of choledocholithiasis. Although transcystic duct extraction has been effective, the integration of flexible endoscopic methodology into the laparoscopic procedure has facilitated management of difficult cases. Variations of endoscopic retrograde cholangiopancreatography may be used during laparoscopic cholecystectomy or facilitated after the surgery by maneuvers at the time of operation. These techniques have been extremely effective in facilitating the laparoscopic treatment of common bile duct stones. Copyright 2001 by W.B. Saunders Company.