Cholelithiasis with Choledocholithiasis

  • Samuel M. Maurice
  • Shishir K. Maithel
  • Benjamin E. Schneider
  • John Morgan Cosgrove
  • James K. Fullerton
  • Gary C. Vitale

Stones in the common duct complicate minimal access management of cholelithiasis. Before the laparoscopic era, open common duct exploration at the time of cholecystectomy was the procedure of choice. In the current era, common duct stones may be managed endoscopically (by endoscopic retrograde cholangiopancreatography [ERCP]) or laparoscopically; ERCP management can occur before, after, or even during laparoscopic cholecystectomy. This chapter explores several alternatives and preferences. A slightly different scenario was discussed in Chapter 5, which discussed gallstone pancreatitis.


Bile Duct Common Bile Duct Laparoscopic Cholecystectomy Common Bile Duct Stone Bile Duct Stone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Aliperti G, Edmundowicz S, et al. Combined endoscopic sphincterotomy and laparoscopic cholecystectomy in patients with choledocholithiasis and cholecystolithiasis. Ann Intern Med 1991;15(10):783-784.Google Scholar
  2. Barr LL, Frame BC, Coulanjon A. Proposed criteria for preoperative endoscopic retro-grade cholangiography in candidates for laparoscopic cholecystectomy. Surg Endosc 1999;13:778-781.CrossRefPubMedGoogle Scholar
  3. Berber E, Engle KL, Garland A, et al. A critical analysis of intraoperative time utilization in laparoscopic cholecystectomy. Surg Endosc 2001;15:161-165.CrossRefPubMedGoogle Scholar
  4. Cotton PB, Geenan JE, Sherman S, et al. Endoscopic Sphincterotomy for stones by experts is safe, even in younger patients with normal ducts. Ann Surg 1998;227:201-204.CrossRefPubMedGoogle Scholar
  5. Cuschieri A, Lezoche E, Morino M, et al. E.A.E.S. multicenter prospective randomized trial comparing two-stage vs. single-stage management of patients with gallstone disease and ductal calculi. Surg Endosc 1999;13:952-957.CrossRefPubMedGoogle Scholar
  6. Freeman ML, Nelson DB, Sherman S, et al. Complications of endoscopic biliary sphinc-terotomy. N Engl J Med 1996;335:909-918.CrossRefPubMedGoogle Scholar
  7. Hakamada K, Sasaki M, Endoh M, Itoh T, Morita T, Konn M. Late development of bile duct cancer after sphincteroplasty: a ten- to twenty-two year follow-up study. Surgery 1997;121:488-492.CrossRefPubMedGoogle Scholar
  8. Hallal A, Amortegui J, Jeroukhimov I, et al. Magnetic resonance cholangiopancreatogra-phy accurately detects common bile duct stones in resolving gallstone pancreatitis. J Am Coll Surg 2005;200(6):869-875.CrossRefPubMedGoogle Scholar
  9. Hamy A, Hennekinne S, Pessaux P, et al. Endoscopic sphincterotomy prior to laparoscopic cholecystectomy for the treatment of cholelithiasis. Surg Endosc 2003;17:872-875.CrossRefPubMedGoogle Scholar
  10. Hawasli A, Lloyd L, Cacucci B, Management of choledocholithiasis in the era of laparoscopic surgery. Am Surg 2000;66(5):425-430.PubMedGoogle Scholar
  11. Heili MJ, Wintz NK, Fowler DL. Choledocholithiasis: endoscopic versus laparoscopic management. Ann Surg 1999;65(2):135-138.Google Scholar
  12. Hong DF, Xin Y, Chen DW. Comparison of laparoscopic cholecystectomy combined with intraoperative endoscopic sphincterotomy and laparoscopic exploration of the com-mon bile duct for cholecystocholedocholithiasis. Surg Endosc 2006;20:424-427.CrossRefPubMedGoogle Scholar
  13. Jones DB, Maithel SK, Schneider BE. Atlas of Minimally Invasive Surgery. Woodbury, CT: Cine-Med, 2006.Google Scholar
  14. Kalimi R, Cosgrove JM, Marini M, Gecelter G, Stark B, Cohen JR. Combined intraopera-tive and laparoscopic cholecystectomy and ERCP: Lessons learned from 29 cases. Surg Endosc 2000;14(3):232-234.CrossRefPubMedGoogle Scholar
  15. Karlson BM, Ekbom A, Arvidsson D, Yuen J, Krusemo UB. Population-based study of cancer risk and relative survival following sphincterotomy for stones in the common bile duct. Br J Surg 1997;84:1235-1238.CrossRefPubMedGoogle Scholar
  16. Liberman MA, Phillips EH, Carroll BL, Fallas MJ, Rosenthal R, Hiatt J. Cost-effective management of complicated choledocholithiasis: laparoscopic transcystic duct exploration or endoscopic sphincterotomy. J Am Coll Surg 1996;182:488-494.PubMedGoogle Scholar
  17. Liu C, Lai E, et al. Combined laparoscopic and endoscopic approach in patients with chole-lithiasis and choledocholithiasis. Surgery 1996;119(5):534-537.CrossRefPubMedGoogle Scholar
  18. Liu TH, Consorti ET, Kawashima A, et al. Patient evaluation and management with selec-tive use of magnetic resonance cholangiography and endoscopic retrograde cholangi-opancreatography before laparoscopic cholecystectomy. Ann Surg 2001;234:33-40.CrossRefPubMedGoogle Scholar
  19. Loperfido S, Angelini G, et al. Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter trial. Gastrointest Endosc 1988;48(1):1-10.CrossRefGoogle Scholar
  20. Macadam RCA, Goodall RJR. Long-term symptoms following endoscopic sphincterotomy for common bile duct stones. Surg Endosc 2004;18(3):363-366.CrossRefPubMedGoogle Scholar
  21. Miller RE, Kimmelstiel FM, Winkler WP. Management of common bile duct stones in the era of laparoscopic cholecystectomy. Am J Surg 1995;169:273-276.CrossRefPubMedGoogle Scholar
  22. Nakajima H, Okubo H, Masuko Y. Intraoperative endoscopic sphincterotomy during lapar-oscopic cholecystectomy. Endoscopy 1996;28(2):264.CrossRefPubMedGoogle Scholar
  23. Nehaus H, Feussner H, Ungeheuer A, Hoffmann W, Siewert JR, Classen M. Prospective evaluation of the use of endoscopic retrograde cholangiography prior to laparoscopic cholecystectomy. Endoscopy 1992;24:745-749.CrossRefGoogle Scholar
  24. Petelin JB. Laparoscopic common bile duct exploration. Surg Endosc 2003;17:1705-1715.CrossRefPubMedGoogle Scholar
  25. Poulose BK, Arbogast PG, Holzman MD. National analysis of in-hospital resource uti-lization in choledocholithiasis management using propensity scores. Surg Endosc 2006;20(2):186-190.CrossRefPubMedGoogle Scholar
  26. Rhodes M, Sussman L, Cohen L, Lewis MP. Randomised trial of laparoscopic exploration of common bile duct versus postoperative endoscopic retrograde cholangiography for common bile duct stones. Lancet. 1998;351(9097):159-161.CrossRefPubMedGoogle Scholar
  27. Saccomani G, Durante V, Magnolia M, et al. Combined endoscopic treatment for chole-lithiasis associated with choledocholithiasis. Surg Endosc 2005;19(7):910-914.CrossRefPubMedGoogle Scholar
  28. Tranter SE, Thompson MH. Comparison of endoscopic sphincterotomy and laparoscopic exploration of the common bile duct. Br J Surg 2002;89:1495-1504.CrossRefPubMedGoogle Scholar
  29. Urbach DR, Khajanchee YS, Jobe BA, Standage BA, Hansen PD, Swanstrom LL. Cost-effective management of common bile duct stones: a decision analysis of the use of endoscopic retrograde cholangiopancreatography (ERCP), intraoperative cholangiography, and laparoscopic common bile duct exploration. Surg Endosc 2001;15(1):4-13.CrossRefPubMedGoogle Scholar
  30. Vitale GC, Larson GM, Wieman TJ, Cheadle WG, Miller FB. The use of ERCP in the management of common bile duct stones in patients undergoing laparoscopic chole-cystectomy. Surg Endosc 1993;7:9-11.CrossRefPubMedGoogle Scholar

Suggested Readings

  1. Enochsson L, Lindberg B, Swahn F, Arnelo U. Intraoperative endoscopic retrograde cholangiopancreatography (ERCP) to remove common bile duct stones during rou-tine laparoscopic cholecystectomy does not prolong hospitalization: a 2-year experi-ence. Surg Endosc 2004;18(3):367-371.CrossRefPubMedGoogle Scholar
  2. Harris HW, Davis BR, Vitale GC. Cholecystectomy after endoscopic cholecystectomy for common bile duct stones: Is surgery necessary? Surg Innov 2005;12:187-194.Google Scholar
  3. Lella F, Bagnolo F, Rebuffat C, et al. Use of the laparoscopic-endoscopic approach, the so-called “rendezvous” technique in cholecystocholedocholithiasis. Surg Endosc 2006;20:419-423.CrossRefPubMedGoogle Scholar
  4. Vitale GC, Rangnekar NJ, Hewlett SC. Advanced interventional endoscopy. Curr Probl Surg 2002;39:968-1053.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Samuel M. Maurice
    • 1
  • Shishir K. Maithel
    • 2
  • Benjamin E. Schneider
    • 3
  • John Morgan Cosgrove
    • 4
  • James K. Fullerton
    • 5
  • Gary C. Vitale
    • 6
  1. 1.Department of SurgeryUniversity of Iowa Hospitals and ClinicsIowa CityUSA
  2. 2.Department of Surgical OncologyMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  3. 3.Harvard Medical SchoolBeth Israel Deaconess Medical CenterBostonUSA
  4. 4.Bronx Lebanon Hospital Center/Albert Einstein CollegeBronxUSA
  5. 5.Springfield ClinicSpringfieldUSA
  6. 6.Department of SurgeryUniversity of Louisville School of MedicineLouisvilleUSA

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