Sequential endo-laparoscopic treatment in patients with common bile calculi

Background. Laparoscopic treatment of common bile duct (CBD) stones is gaining great acceptance worldwide, but actually it requires skills and technologies too expensive for a great part of general surgeons. So endoscopic removal of CBD stones before cholecystectomy is usually performed. Since 1991 in our departement we started a policy of selective preoperative cholangiopancreatography (ERCP) in patients suspected for choledocolitiasis and waiting for laparoscopic cholecystectomy. Methods. A retrospective study has been made on a population of 1100 patients who underwent elective laparoscopic cholecystectomy in the period between January 1991 and December 1997. They were 391 male and 719 female with a mean age of 52 years, 126 of whom (11.5%) were selected to have ERCP preoperatively because they had clinical, biochemical and ultrasound signs of the presence of common bile duct stones (CBDS). Results. Succesful cannulation of the CBD was achieved in 124 cases (98.4%), with failures du...