Skip to main content
SpringerLink
Log in

Cholecystocholedocholithiasis: Two-stage Treatment

  • Chapter
Biliary Lithiasis

Abstract

Choledocholithiasis, literally the presence of gallstones in the common bile duct (CBD), occurs in 15–20% of patients with cholecystolithiasis. The majority of gallstones are believed to form in the gallbladder where they pass into the CBD via the cystic duct. CBD stones (CBDS) can also be found in patients who have an apparently normal gallbladder; such patients represent about 10% of those with choledocholithiasis. In addition, approximately 5% of patients who have undergone a cholecystectomy have retained or recurrent stones [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hermann RE (1989) The spectrum of biliary stone disease. Am J Surg 158:171–173

    Article  PubMed  CAS  Google Scholar 

  2. Cotton PB, Geenen JE, Sherman S et al (1998) Endoscopic sphincterotomy for stones by experts is safe, even in younger patients with normal ducts. Ann Surg 227:201–204

    Article  PubMed  CAS  Google Scholar 

  3. No authors listed (1991) A prospective analysis of 1518 laparoscopic cholecystectomies. The Southern Surgeons Club. N Engl J Med 324:1073–1078. Erratum in: N Engl J Med 325:1517–1518

    Article  Google Scholar 

  4. Baird DR, Wilson JP, Mason EM et al (1992) An early review of 800 laparoscopic cholecystectomies at a university-affiliated community teaching hospital. Am Surg 58:206–210

    PubMed  CAS  Google Scholar 

  5. Larson GM, Vitale GC, Casey J et al (1992) Multipractice analysis of laparoscopic cholecystectomy in 1,983 patients. Am J Surg 163:221–226

    Article  PubMed  CAS  Google Scholar 

  6. Arregui ME, Davis CJ, Arkush AM, Nagan RF (1992) Laparoscopic cholecystectomy combined with endoscopic sphincterotomy and stone extraction or laparoscopic choledochoscopy and electrohydraulic lithotripsy for management of cholelithiasis with choledocholithiasis. Surg Endosc 6:10–15

    Article  PubMed  CAS  Google Scholar 

  7. Frazee RC, Roberts J, Symmonds R et al (1993) Combined laparoscopic and endoscopic management of cholelithiasis and choledocholithiasis. Am J Surg 166:702–705; discussion 705–706

    Article  PubMed  CAS  Google Scholar 

  8. Graham SM, Flowers JL, Scott TR et al (1993) Laparoscopic cholecystectomy and common bile duct stones. The utility of planned perioperative endoscopic retrograde cholangiography and sphincterotomy: experience with 63 patients. Ann Surg 218:61–67

    Article  PubMed  CAS  Google Scholar 

  9. Leitman IM, Fisher ML, McKinley MJ et al (1993) The evaluation and management of known or suspected stones of the common bile duct in the era of minimal access surgery. Surg Gynecol Obstet 176:527–533

    PubMed  CAS  Google Scholar 

  10. Barkun AN, Barkun JS, Fried GM et al (1994) Useful predictors of bile duct stones in patients undergoing laparoscopic cholecystectomy. McGill Gallstone Treatment Group. Ann Surg 220:32–39

    Article  PubMed  CAS  Google Scholar 

  11. Meyer C, de Manzini N, Rohr S et al (1994) Treatment of lithiasis of the common bile duct by endoscopic sphincterotomy and laparoscopic cholecystectomy. Ann Chir 48:31–36

    PubMed  CAS  Google Scholar 

  12. Salky BA (1994) Laparoscopic management of common bile duct stones. Surg Endosc 8:1161–1162

    Article  PubMed  CAS  Google Scholar 

  13. Voyles CR, Sanders DL, Hogan R (1994) Common bile duct evaluation in the era of laparoscopic cholecystectomy. 1050 cases later. Ann Surg 219:744–750; discussion 750–752

    PubMed  CAS  Google Scholar 

  14. Rieger R, Sulzbacher H, Woisetschläger R et al (1994) Selective use of ERCP in patients undergoing laparoscopic cholecystectomy. World J Surg 18:900–904; discussion 904–905

    Article  PubMed  CAS  Google Scholar 

  15. Rijna H, Borgstein PJ, Meuwissen SG et al (1995) Selective preoperative endoscopic retrograde cholangiopancreatography in laparoscopic biliary surgery. Br J Surg 82:1130–1133

    Article  PubMed  CAS  Google Scholar 

  16. Tanaka M, Sada M, Eguchi T et al (1996) Comparison of routine and selective endoscopic retrograde cholangiography before laparoscopic cholecystectomy. World J Surg 20:267–70; discussion 271

    Article  PubMed  CAS  Google Scholar 

  17. Bonatsos G, Leandros E, Polydorou et al (1996) ERCP in association with laparoscopic cholecystectomy. A strategy to minimize the number of unnecessary ERCPs. Surg Endosc 10:37–40

    Article  PubMed  CAS  Google Scholar 

  18. Kullman E, Borch K, Lindström E et al (1996) Management of bile duct stones in the era of laparoscopic cholecystectomy: appraisal of routine operative cholangiography and endoscopic treatment. Eur J Surg 162:873–880

    PubMed  CAS  Google Scholar 

  19. Masci E, Fanti L, Mariani A et al (1999) Selection criteria for pre-operative endoscopic retrograde cholangiography and endoscopic-laparoscopic treatment of biliary stones. Eur J Gastroenterol Hepatol 11:781–784

    Article  PubMed  CAS  Google Scholar 

  20. Bergamaschi R, Tuech JJ, Braconier L et al (1999) Selective endoscopic retrograde cholangiography prior to laparoscopic cholecystectomy for gallstones. Am J Surg 178:46–49

    Article  PubMed  CAS  Google Scholar 

  21. Coppola R, Riccioni ME, Ciletti S et al (2001) Selective use of endoscopic retrograde cholangiopancreatography to facilitate laparoscopic cholecystectomy without cholangiography. A review of 1139 consecutive cases. Surg Endosc 15:1213–1216

    Article  PubMed  CAS  Google Scholar 

  22. Romano F, Franciosi CM, Caprotti R et al (2002) Preoperative selective endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy without cholangiography. Surg Laparosc Endosc Percutan Tech 12:408–411

    Article  PubMed  Google Scholar 

  23. Schreurs WH, Juttmann JR, Stuifbergen WN et al (2002) Management of common bile duct stones: selective endoscopic retrograde cholangiography and endoscopic sphincterotomy: short-and longterm results. Surg Endosc 16:1068–1072

    Article  PubMed  CAS  Google Scholar 

  24. Hamy A, Hennekinne S, Pessaux P et al (2003) Endoscopic sphincterotomy prior to laparoscopic cholecystectomy for the treatment of cholelithiasis. Surg Endosc 17:872–875

    Article  PubMed  CAS  Google Scholar 

  25. Katz D, Nikfarjam M, Sfakiotaki A, Christophi C (2004) Selective endoscopic cholangiography for the detection of common bile duct stones in patients with cholelithiasis. Endoscopy 36:1045–1049

    Article  PubMed  CAS  Google Scholar 

  26. Freeman ML, Nelson DB, Sherman S et al (1996) Complications of endoscopic biliary sphincterotomy. N Engl J Med 335:909–918

    Article  PubMed  CAS  Google Scholar 

  27. Wojtun S, Gil J, Gietka W, Gil M (1997) Endoscopic sphincterotomy for choledocholithiasis: a prospective single-center study on the short-term and long-term treatment results in 483 patients. Endoscopy 29:258–265

    Article  PubMed  CAS  Google Scholar 

  28. Bergman JJ, van der Mey S, Rauws EA et al (1996) Long-term follow-up after endoscopic sphincterotomy for bile duct stones in patients younger than 60 years of age. Gastrointest Endosc 44:643–649

    Article  PubMed  CAS  Google Scholar 

  29. Prat F, Malak NA, Pelletier G et al (1996) Biliary symptoms and complications more than 8 years after endoscopic sphincterotomy for choledocholithiasis. Gastroenterology 110:894–899

    Article  PubMed  CAS  Google Scholar 

  30. Saito M, Tsuyuguchi T, Yamaguchi T et al (2000) Long-term outcome of endoscopic papillotomy for choledocholithiasis with cholecystolithiasis. Gastrointest Endosc 51:540–545

    Article  PubMed  CAS  Google Scholar 

  31. Lau JY, Leow CK, Fung TM et al (2006) Cholecystectomy or gallbladder in situ after endoscopic sphincterotomy and bile duct stone removal in Chinese patients. Gastroenterology 130:96–103

    Article  PubMed  Google Scholar 

  32. Boerma D, Rauws EA, Keulemans YC et al (2002) Wait-and-see policy or laparoscopic cholecystectomy after endoscopic sphincterotomy for bileduct stones: a randomised trial. Lancet 360:761–765

    Article  PubMed  Google Scholar 

  33. Shaw MJ, Mackie RD, Moore JP et al (1993) Results of a multicenter trial using a mechanical lithotripter for the treatment of large common bile duct stones. Am J Gastroenterol 88:730–733

    PubMed  CAS  Google Scholar 

  34. Pring CM, Skelding-Millar L, Goodall RJ (2005) Expectant treatment of cholecystectomy after endoscopic retrograde cholangiopancreatography for choledocholithiasis in patients over 80 years old? Surg Endosc 19:357–360

    Article  PubMed  CAS  Google Scholar 

  35. Collins C, Maguire D, Ireland A et al (2004) A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy: natural history of choledocholithiasis revisited. Ann Surg 239:28–33

    Article  PubMed  Google Scholar 

  36. Cuschieri A, Dubois F, Mouiel J et al (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161:385–387

    Article  PubMed  CAS  Google Scholar 

  37. Tham TC, Lichtenstein DR, Vandervoort J et al (1998) Role of endoscopic retrograde cholangio pancreatography for suspected choledocholithiasis in patients undergoing laparoscopic cholecystectomy. Gastrointest Endosc 47:50–56

    Article  PubMed  CAS  Google Scholar 

  38. Rieger R, Wayand W (1995) Yield of prospective, noninvasive evaluation of the common bile duct combined with selective ERCP/sphincterotomy in 1390 consecutive laparoscopic cholecystectomy patients. Gastrointest Endosc 42:6–12

    Article  PubMed  CAS  Google Scholar 

  39. Materia A, Pizzuto G, Silecchia G et al (1996) Sequential endoscopic-laparoscopic treatment of cholecystocholedocholithiasis. Surg Laparosc Endosc 6:273–277

    Article  PubMed  CAS  Google Scholar 

  40. Zaninotto G, Costantini M, Rossi M et al (1996) Sequential intraluminal endoscopic and laparoscopic treatment for bile duct stones associated with gallstones. Surg Endosc 10:644–648

    PubMed  CAS  Google Scholar 

  41. Valvano L, Tassetti V, Vix M et al (1997) Sequential treatment of lithiasis of the common bile duct. Ann Ital Chir 68:315–319; discussion 319–320

    PubMed  CAS  Google Scholar 

  42. Suc B, Escat J, Cherqui D et al (1998) Surgery vs endoscopy as primary treatment in symptomatic patients with suspected common bile duct stones: a multicenter randomized trial. French Associations for Surgical Research. Arch Surg 133:702–708

    Article  PubMed  CAS  Google Scholar 

  43. Solana de Lope J, Aguilera E et al (1998) Endoscopic retrograde cholangiopancreatography prior to laparoscopic cholecystectomy in patients with suspected choledocholithiasis. Rev Gastroenterol Mex 63:77–81

    PubMed  CAS  Google Scholar 

  44. Cuschieri A, Lezoche E, Morino M et al (1999) EAES multicenter prospective randomized trial comparing two-stage vs single-stage management of patients with gallstone disease and ductal calculi. Surg Endosc 13:952–957

    Article  PubMed  CAS  Google Scholar 

  45. Hoyuela C, Cugat E, Bretcha P et al (1999) Must ERCP Be routinely performed if choledocholithiasis is suspected. Dig Surg 16:411–444

    Article  PubMed  CAS  Google Scholar 

  46. Meyer C, Le JV, Rohr S et al (1999) Management of common bile duct stones by laparoscopic cholecystectomy and endoscopic sphincterotomy: pre, per-or postoperative sphincterotomy? Dig Surg 16:26–31

    Article  PubMed  CAS  Google Scholar 

  47. Franciosi C, Caprotti R, De Fina S et al (2000) Sequential endo-laparoscopic treatment in patients with common bile calculi. Minerva Chir; 55:665–671

    PubMed  CAS  Google Scholar 

  48. Sgourakis G, Karaliotas K (2002) Laparoscopic common bile duct exploration and cholecystectomy versus endoscopic stone extraction and laparoscopic cholecystectomy for choledocholithiasis. A prospective randomized study. Minerva Chir 57:467–474

    PubMed  CAS  Google Scholar 

  49. Nardi M Jr, Perri SG, Pietrangeli F et al (2002) “Sequential” treatment: is it the best alternative in cholecysto-choledochal lithiasis? Chir Ital 54:785–798

    PubMed  Google Scholar 

  50. Sarli L, Iusco DR, Roncoroni L (2003) Preoperative endoscopic sphincterotomy and laparoscopic cholecystectomy for the management of cholecystocholedocholithiasis: 10-year experience. World J Surg 27:180–186

    PubMed  Google Scholar 

  51. Rábago LR, Vicente C, Soler F (2006) Two-stage treatment with preoperative endoscopic retrograde cholangiopancreatography (ERCP) compared with single-stage treatment with intraoperative ERCP for patients with symptomatic cholelithiasis with possible choledocholithiasis. Endoscopy 8:779–786

    Article  Google Scholar 

  52. Morino M, Baracchi F, Miglietta C et al (2006) Preoperative endoscopic sphincterotomy versus laparoendoscopic Rendez-vous in patients with gall-bladder and bile duct stones. Ann Surg 244:889–896; discussion 893–896

    Article  PubMed  Google Scholar 

  53. Widdison AL, Longstaff AJ, Armstrong CP (1994) Combined laparoscopic and endoscopic treatment of gallstones and bile duct stones. Br J Surg 81:595–597

    Article  PubMed  CAS  Google Scholar 

  54. Cuschieri A, Croce E, Faggioni A et al (1996) EAES ductal stone study. Preliminary finding of multi-center prospective randomized trial comparing two-stage versus single-stage management. Surg Endosc 10:1130–1135

    Article  PubMed  CAS  Google Scholar 

  55. Cuschieri A (1996) Of stones and bile ducts: single versus two-stage management. Surg Endosc 10:1124

    Article  PubMed  CAS  Google Scholar 

  56. Alponat A, Kum CK, Rajnakova A et al (1997) Predictive factors for synchronous common bile duct stones in patients with choledocholithiasis. Surg Endosc 11:928–982

    Article  PubMed  CAS  Google Scholar 

  57. Soto JA, Barish MA, Yucel EK et al (1996) Magnetic resonance cholangiography: comparison with endoscopic retrograde cholangiopancreatography. Gastroenterology 110:589–597

    Article  PubMed  CAS  Google Scholar 

  58. Buscarini E, Tansini P, Vallisa D et al (2003) EUS for suspected choledocholithiasis: Do benefits outweigh costs? A prospective, controlled study. Gastrointest Endosc 57:510

    Article  PubMed  Google Scholar 

  59. Cotton PB, Lehman G, Vennes J et al (1991) Endoscopic sphincterotomy, complications and their management. An attempt at consensus. Gastrointest Endosc 37:383–393

    Article  PubMed  CAS  Google Scholar 

  60. Reiertsen O, Skjoto J, Jacobsen CD, Rosseland AR (1987) Complications of fibroptic gastrointestinal endoscopic. Five years experience in a central hospital. Endoscopy 19:1–6

    Article  PubMed  CAS  Google Scholar 

  61. Cotton PB (1993) Endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. Am J Surg 165:474–478

    Article  PubMed  CAS  Google Scholar 

  62. Clayton ESJ, Connor S, Alexakis N and Leandros E (2006) Meta-analysis of endoscopy and surgery versus surgery alone for common bile duct stones with the gallbladder in situ. Br J Surg 93:1185–1191

    Article  PubMed  CAS  Google Scholar 

  63. Poulose BK, Arbogast PG, Holzman MD (2006) National analysis of in-hospital resource utilization in choledocholithiasis management using propensity scores. Surg Endosc 20:186–190

    Article  PubMed  CAS  Google Scholar 

  64. Basso N, Pizzuto G, Surgo D et al (1999) Laparoscopic cholecystectomy and intraoperative endoscopic sphincterotomy in the treatment of cholecysto-choledocholithiasis. Gastrointest Endosc 50:532–535

    Article  PubMed  CAS  Google Scholar 

  65. Meyer C, Le JV, Rohr S et al (1999) Management of common bile duct stones in a single operation combining laparoscopic cholecystectomy and perioperative endoscopic sphincterotomy. Surg Endosc 13:874–877

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery Minimally Invasive Surgery Centre, University of Turin, Turin, Italy

    Mario Morino & Alberto Arezzo

Authors
  1. Mario Morino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alberto Arezzo
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Italia

About this chapter

Cite this chapter

Morino, M., Arezzo, A. (2008). Cholecystocholedocholithiasis: Two-stage Treatment. In: Biliary Lithiasis. Springer, Milano. https://doi.org/10.1007/978-88-470-0763-5_24

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-0763-5_24

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0762-8

  • Online ISBN: 978-88-470-0763-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation