Laparoscopic cholecystectomy and choledochoscopy for the treatment of cholelithiasis and choledocholithiasis.
A 33-year-old woman with symptomatic cholelithiasis underwent laparoscopic cholecystectomy. Preoperative evaluation did not suggest the presence of choledocholithiasis, but intraoperative cholangiography showed a totally obstructing stone in the distal common bile duct. Laparoscopically directed, transperitoneal choledochoscopy was performed by passing a 9.4 F flexible ureteroscope through the cystic duct into the distal common bile duct. A single calculus was visualized and removed with a basket. The patient was discharged the next day, returned to full activity within 1 week, and has done well in the subsequent postoperative interval. The management of incidentally discovered common bile duct stones during performance of laparoscopic cholecystectomy is discussed.
Smith
P C
PC
Department of Surgery, Washington University School of Medicine, St. Louis, Mo.
Clayman
R V
RV
Soper
N J
NJ
D000328:Adult; D002758:Cholangiography; D002763:Cholecystectomy / Q000379:methods*; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D006500:Hepatic Duct, Common / Q000473:pathology*; D006801:Humans; D010535:Laparoscopy; D011184:Postoperative Period