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Transcystic Stenting and Post-Operative ERCP for CBD Stones at Laparoscopic Cholecystectomy

  • Michael R. Cox
Chapter

Abstract

The clinical presentation and management of common bile duct stones or anticipated common bile duct stones is discussed in Chaps. 6, 7, 8 and 17. Briefly, unless a patient present with cholangitis or possibly persistent jaundice the better outcomes are associated with proceeding directly to a laparoscopic cholecystectomy with operative cholangiogram and either laparoscopic transcystic exploration (Chap. 20) or post-operative ERCP. A recent meta-analysis demonstrated that pre-operative ERCP is associated with a higher morbidity than either post-operative ERCP or intra-operative laparoscopic exploration [1]. Furthermore, intraoperative ERCP has a poorer outcome compared to post-operative ERCP or laparoscopic operative exploration [1]. However, there is no apparent difference between laparoscopic transcystic exploration techniques or post-operative ERCP.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Sydney and Nepean HospitalPenrithAustralia

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