LAPAROSCOPIC CHOLEDOCHOTOMY

Aim: The latest advance in management of common bile duct (CBD) stones is laparoscopic common bile duct exploration (LCBDE). We present our experience in management of patients with CBD stones by the LCBDE. Methods: Between February 2006 and May 2008, 58 patients with CBD stones had been operated by LCBDE in Mansoura Gastroenterology Surgical Center. Patients considered for LCBDE were those who were found to have CBD stones with a dilated CBD 10 mm or more, in the absence of cholangitis, pancreatitis or contraindication to laparoscopy. All patients had been treated by laparoscopic choledochotomy. Results: The operation was completed laparoscopically in 52 (89.7%) and only 5 (8.6%) patients were converted to an open procedure. One patient had intraoperative endoscopic retrograde cholangiopancreatography (ERCP). The CBD was closed around T-tube in 35 patients, 13 had primary closure and 4 had choledochoduodenostomy. No mortality or intraoperative complications were reported but 2 patients had postoperative complications. Retained CBD stones were detected in 2 patients. Conclusion: LCBDE is both feasible and safe. Biliary surgeons should aim to master LCBDE as an essential surgical option in CBD stone management