Laparoscopic Cholecystectomy / LCBD Exploration and Choledochoduodenostomy

Choledocholithiasis is a common complication of cholecystolithiasis. Treatment is advisable to prevent further complications. Different methods have been used for the treatment of CBDS but the suitable therapy depends on conditions such as patient' satisfaction, number and size of stones, and the surgeons experience in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD exploration (transcystic or transcholedochal), or laparotomy with CBD exploration (by T-tube, C-tube insertion, or primary closure) are the most commonly used methods managing CBDS. The optimal treatment for common bile duct (CBD) stones is still unclear but with advances in laparoscopic instrumentation and acquisition of advanced laparoscopic skills, laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis is increasing in popularity among surgeons worldwide. LCBDE can be performed transcystic or by direct choledochotomy. Laparoscopic transcholedochal CBD exploration is preferable since it provides complete access to the ductal system. Today's option for biliary bypass procedures, for difficult choledocholithiasis is laparoscopic choledochoduodenostomy.