The role of biliodigestive derivations in the treatment of choledocholithiasis.

The obstructive jaundice is a complex syndrome with both benign etiology (choledocholithiasis, hydatid cyst, chronic pancreatitis) and malignant (cancer of the pancreas, cholangiocarcinoma and gallbladder cancer) and it has a special place in biliopancreatic pathology, with up most importance due to changes in local and general status of the organism, difficult etiologic diagnostic problems for the clinician and whose solution requires teamwork, which involves both the surgeon, gastroenterologist, anesthesiologist etc. The introduction of laparoscopic approach and upper gastrointestinal endoscopy for gallstone disease giving the opportunity to solve choledocholithiasis only by laparoscopic approach or by combining laparoscopic cholecystectomy with extraction of the common bile duct stones using endoscopic retrograde cholangiopancreatography, which greatly restricted the classical surgical indications. In these circumstances, I consider appropriate to review the place and indications of biliodigestive derivations in obstructive jaundice caused by coledocholithiasis.