Laparoscopic Common Bile Duct Exploration By Choledochotomy.

Choledocholithiasis uncomplicated by acute ascending cholangitis is being treated by a two step approach involving two separate teams of specialized care resulting in more expense and potentiating possible complications. Laparoscopic common bile duct exploration by choledochotomy is a capable means of managing this problem in a one step fashion. The experience with 137 patients has resulted in a 94.1% success rate in technically clearing the common bile duct with a 2.2% retained stone rate all of which were removed by postoperative endoscopic retrograde cholangio pancreatography. Conversion to open procedure was in five patients (3.6%). Laparoscopic common bile duct exploration by choledochotomy depends on routine intraoperative fluorocholangiography (99.7% successful) and is especially useful with proximal stones or multiple, large stones.