Surgical Endoscopy

, Volume 22, Issue 8, pp 1826–1831 | Cite as

Laparoscopic common bile duct exploration after failed endoscopic stone extraction

  • Constantine Karaliotas
  • George Sgourakis
  • Constantine Goumas
  • Nickolaos Papaioannou
  • Constantine Lilis
  • Emmanouel Leandros



Our objective was to present the technical aspects and results of laparoscopic common bile duct (CBD) exploration following failed endoscopic stone extraction.


From April 1997 to December 2006, 32 patients were referred to us after unsuccessful attempts at endoscopic CBD stone extraction. Transcholedochal laparoscopic CBD exploration was used in all patients. Previous operations, several pathologic entities, and stone impaction were studied as potential predictors of failure of the laparoscopic approach.


Previous operations, cholangitis, anatomic abnormalities, and stone impaction were the principal reasons for failure of endoscopic retrograde cholangiopancreatography (ERCP). Stone extraction under direct laparoscopic choledochotomy was achieved in 20 of 31 patients (64.51%). Biliary stents were inserted in 7 patients (21.8%) and T tubes were placed in 21 patients (65.6%). Five laparoscopic choledochoduodenostomies were performed. There were 11 conversions to open surgery. Morbidity was 12.5%.


Laparoscopic choledochotomy is an efficacious procedure in dealing with unsuccessful endoscopic CBD clearance.


Choledocholithiasis Endoscopic stone extraction Laparoscopic CBD exploration Laparoscopic choledochotomy 



common bile duct


laparoscopic cholecystectomy


endoscopic retrograde cholangiopancreatography


endoscopic sphincterotomy


percutaneous transhepatic biliary drainage


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Constantine Karaliotas
    • 1
  • George Sgourakis
    • 1
  • Constantine Goumas
    • 2
  • Nickolaos Papaioannou
    • 1
  • Constantine Lilis
    • 1
  • Emmanouel Leandros
    • 3
  1. 1.2nd Surgical Department of Korgialenion – BenakionRed Cross HospitalAthensGreece
  2. 2.Department of Gastroenterology of Korgialenion – BenakionRed Cross HospitalAthensGreece
  3. 3.1st Propaedeutic Surgical Department of National Kappodistrian UniversityHippocration HospitalAthensGreece

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