Laparoscopic Bile Duct Exploration

  • Leslie NathansonEmail author


The majority of bile duct stones are secondary bile duct stones (Chap.  3) that arise in the gallbladder and migrate down the cystic duct. Depending on geographic variation in this incidence of secondary duct stones, trans-cystic exploration successfully clears the bile duct (CBD) in 60–70% of patients; the remainder can be removed by choledochotomy or post-operative endoscopic retrograde cholangiopancreatography (ERCP).


  1. 1.
    Krauss H, Kern E. Some current problems of biliary tract surgery: indication and technique for choledochotomy, intra-operative cholangiomanometry, primary closure of the common bile duct. Surgery. 1967;62:983–7.PubMedGoogle Scholar
  2. 2.
    Sheen-Chen SM, Chou FF. Choledochotomy for biliary lithiasis: is routine T-tube drainage necessary? A prospective trial. Acta Chir Scan. 1990;156:387–90.Google Scholar
  3. 3.
    De Roover D, Vendenveken M, Gerard Y. Choledochotomy: a prospective trial. Acta Surg Belg. 1989;89:320–4.Google Scholar
  4. 4.
    Williams JAR, Traecy PJ, Sidey P, Worthley CS, Townsend NCW, Russell EAD. Primary duct closure verses T-tube drainage following exploration of the common bile duct. Aust N Z J Surg. 1994;64:823–6.CrossRefGoogle Scholar
  5. 5.
    Heinerman PM, Boeckl O, Pimpl W. Selective ERCP and pre-operative stone removal in bile duct surgery. Ann Surg. 1989;209:267–72.CrossRefGoogle Scholar
  6. 6.
    Escourrou J, Cordova JA, Lazorthes F, Frexinos J, Ribert A. Early and late complications after endoscopic sphincterotomy with and without the gallbladder in situ. Gut. 1984;25:598–602.CrossRefGoogle Scholar
  7. 7.
    Stain SC, Cohen H, Tsuishoyska M, Donovan AJ. Choledocholithiasis: endoscopic sphincterotomy or common bile duct exploration. Ann Surg. 1991;213:627–34.CrossRefGoogle Scholar
  8. 8.
    Wilson TG, Jeans PL, Anthony A, Cox MR, Toouli J. Laparoscopic cholecystectomy and management of choledocholithiasis. Aust N Z J Surg. 1993;63:443–50.CrossRefGoogle Scholar
  9. 9.
    Cotton PB, Baillie J, Pappas TN, Meyers WS. Laparoscopic cholecystectomy and the biliary endoscopist. Gastrointest Endosc. 1991;37:94–6.CrossRefGoogle Scholar
  10. 10.
    Dias MM, Martin CJ, Cox MR. Patterns of management of common bile duct stones in the laparoscopic era: a NSW survey. Aust N Z J Surg. 2002;72:181–5.CrossRefGoogle Scholar
  11. 11.
    Sandzen B, Haapamaki MM, Nilsson E, et al. Treatment of Common Bile Duct Stones in Sweden 1989-2006: an Observational Nationwide Study of a Paradigm Shift. World J Surg. 2012;36:2146–53.CrossRefGoogle Scholar
  12. 12.
    Liu TH, Consorti ET, Kawashima A, et al. Patient evaluation with selective use of magnetic resonance cholangiography and endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy. Ann Surg. 2001;234:33–40.CrossRefGoogle Scholar
  13. 13.
    Nagaraja V, Cox MR, Eslick GD. Systematic review and meta-analysis of the minimally invasive techniques for the management of cholecysto-choledocholithiasis. J Hepatobil Panc Sci. 2014;21:896–901.CrossRefGoogle Scholar
  14. 14.
    Menzies D, Motson RW. Operative common bile duct imaging by operative cholangiography and flexible choledochoscopy. BJS. 1992;79:815–7.CrossRefGoogle Scholar
  15. 15.
    Motson RW, Wetter LA. operative choledochoscopy: Common bile duct exploration is incomplete without it. BJS. 1990;77:968–74.CrossRefGoogle Scholar
  16. 16.
    Blind PJ, Lundmark M. Management of bile duct stones: lithotripsy by laser, electrohydraulic, and ultrasonic techniques. Eur J Surg. 1998;164:403–9.CrossRefGoogle Scholar
  17. 17.
    Cuschieri A, Lezoche E, Mornino M, et al. E.A.E.S. multicenter prospective randomized trial comparing two- stage vs single-stage management of patients with gall- stone disease and ductal calculi. Surg Endosc. 1999;13:952–7.CrossRefGoogle Scholar
  18. 18.
    Rhodes M, Sussman L, Cohen L, Lewis MP. Randomized trial of laparoscopic exploration of common bile duct versus postoperative endoscopic retrograde cholangiography for common bile duct stones. Lancet. 1998;351:159–61.CrossRefGoogle Scholar
  19. 19.
    Noble H, Tranter S, Chesworth T, et al. A randomized, clinical trial to compare endoscopic sphincterotomy and subsequent laparoscopic cholecystectomy with primary laparoscopic bile duct exploration during cholecystectomy in higher risk patients with choledocholithiasis. J Laparoendosc Adv Surg Tech A. 2009;19:713–20.CrossRefGoogle Scholar
  20. 20.
    Rogers SJ, Cello JP, Horn JK, et al. Prospective randomized trial of LC + LCBDE vs ERCP/S + LC for common bile duct stone disease. Arch Surg. 2010;145(1):28–33.CrossRefGoogle Scholar
  21. 21.
    Sgourakis G, Karaliotas K. Laparoscopic common bile duct exploration and cholecystectomy vs endoscopic stone extraction and laparoscopic cholecystectomy for choledocholithiasis. A prospective randomized study. Minerva Chir. 2002;57:467–74.PubMedGoogle Scholar
  22. 22.
    Nathanson LK, Shaw IM. Gallstones. In: Garden OJ, editor. Hepatobiliary and pancreatic surgery. 3rd ed. London: Elsevier; 2005. p. 181.Google Scholar
  23. 23.
    Nathanson LK, O’Rourke NA, Martin IJ, et al. Post- operative ERCP versus laparoscopic choledochotomy for clearance of selected bile duct calculi: a randomized trial. Ann Surg. 2005;242:188–92.CrossRefGoogle Scholar
  24. 24.
    Traverso LW. A cost analysis of the treatment of common bile duct stones discovered during cholecystectomy. Semin Laparosc Surg. 2000;7:302–7.CrossRefGoogle Scholar
  25. 25.
    Urbach DR, Khanjanchee YS, Jobe BA, et al. Cost-effective management of common bile duct stones. Surg Endosc. 2001;15:4–13.CrossRefGoogle Scholar
  26. 26.
    Bourke MJ, Elfant AB, Alhalel R, et al. Sphincterotomy-associated biliary strictures: features and endoscopic management. Gastrointest Endosc. 2000;52(4):494–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Wesley HospitalBrisbaneAustralia

Personalised recommendations