Management of common bile-duct stones and associated gallbladder stones: surgical aspects

摘要: For many years, open exploration of the common bile duct has been treatment choice for patients with bile-duct stones. During recent decades endoscopic sphincterotomy gained wide acceptance as an effective and less invasive alternative. After sphincterotomy, subsequent (laparoscopic) cholecystectomy is warranted in gallbladder This chapter will discuss whether should be performed prior to, during or after cholecystectomy, also address question single-stage by laparoscopic fact preferable. The rate recurrent choledocholithiasis biliary can reach more than 20%. review focuses on risk factors--delayed clearance bactobilia--that may lead to primary stone formation. Underlying altered composition (relative phospholipid deficiency) recognised a subgroup patients. Identification these factors significantly affect policy.