Laparoscopic transcystic papillotomy under endoscopic control for bile duct stones.

We present here a laparoscopic transcystic papillotomy technique for the management of bile duct stones discovered either preoperatively or on intraoperative cholangiogram. Papillotomy is performed orthogradely with a hydrophilic wire-guided spincterotome inserted through the cystic duct. The correct position of the diathermic wire is verified with peroral duodenoscopy. The method has proved save and effective in our first 12 consecutive patients. Further evaluation is required to clarify its potential role in laparoscopic biliary surgery.