traitement laparoscopique de la lithiase choledocienne

In a period of five years we operated 52 patients affected by choledocolithiasis. 38 patients had a laparoscopic approach, 10 patients had directly a laparotomy and 4 patients benefit of a sequential treatment, The conversion rote was 39% because we don't select candidates to laparoscopy, including even patients with acute cholangitis. Main causes of conversion were wedged calculi in the papilla, multiple stones and high inflammation of the common bile duct. Mortality and morbidity were nil. Duration of laparoscopic operation was in a mean of 165 minutes with 8,8 days of hospital stay. Two residual stones were successfully removed by endoscopic sphincterotomy. Lapnroscopic treatment of choledocolithiasis is an effective, safe method; it seems to be the best therapeutic alternative. This technique needs an additional and costly instrumentation and good laparoscopic skills. in order to reduce the conversion rate it is recommended to avoid the laparoscopic approach for patients with acute chotangitis and multiple common bile duct stones