Combined endoscopic - laparoscopic treatment of cholecystocholedocholithiasis

ABSTRACT

The aim of this study was to evaluate prospectively the results of the combined endoscopic-laparoscopic management in patients with gallstones and suspected common bile duct [CBD] stones. From November 1994 to May 1999, 600 consecutive patients were evaluated for laparoscopic cholecystectomy [LC]. The preoperative workup included clinical history and physical examination, serum levels of bilirubin, alkaline phosphatase and amylase and ultrasonography. Preoperative ERCP was indicated in cases with previous or present jaundice or acute pancreatitis, altered liver or pancreatic blood tests, dilated CBD [>8 mm] and CBD stones at ultrasonography. If CBD pathology was confirmed, endoscopic sphincterotomy [ES] was performed and treatment was attempted. All patients were assigned to undergo LC within 48 hours. Morbidity, mortality, hospital stay and disabilities were recorded