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Management of common bile duct stones

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery

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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Authors and Affiliations

  1. Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois

    Eric S. Hungness M.D. & Nathaniel J. Soper M.D. (Professor and Vice-Chair for Clinical Affairs, Director of Minimally Invasive Surgery)

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  1. Eric S. Hungness M.D.
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  2. Nathaniel J. Soper M.D.
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Correspondence to Nathaniel J. Soper M.D..

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Hungness, E.S., Soper, N.J. Management of common bile duct stones. Journal of Gastrointestinal Surgery 10, 612–619 (2006). https://doi.org/10.1016/j.gassur.2005.08.015

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