[Endoscopy and laparoscopy in the treatment of lithiasic cholecystitis associated with benign bile duct obstruction].
OBJECTIVE
To analyze the efficacy of a combined approach using ERCP plus laparoscopic cholecystectomy in the treatment of gallstones associated to benign common bile duct obstruction.


METHODS
Prospective study.


METHODS
Tertiary-care medical center.


METHODS
From a total of 270 laparoscopic cholecystectomies performed between October 1991 and January 1994, a group of 25 patients in whom preoperative ERCP was performed to rule out bile duct obstruction was selected for analysis.


RESULTS
Choledocholithiasis was documented in nine patients (36%). In eight of them, stones were retrieved by ERCP. The diagnosis of odditis was established in five patients and a papilotomy was performed. The entire bile duct was normal in 11 cases. All patients in whom the common bile duct was normal, or cleared endoscopically, underwent laparoscopic cholecystectomy uneventfully. There was one complication of papilotomy. Duodenal perforation occurred in one patient who ultimately died.


CONCLUSIONS
The combined approach using ERCP followed by laparoscopic cholecystectomy seems to be adequate for the treatment of gallstones associated to bile duct obstruction.
Palacios-Macedo
A
A
Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Herrera
M F
MF
Morán
M A
MA
González García
M
M
Chan Núñez
C
C
Hernández-Ortiz
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D014670:Ampulla of Vater / Q000601:surgery; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery*; D004386:Duodenum / Q000293:injuries; D005260:Female; D042882:Gallstones / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D009803:Sphincter of Oddi / Q000601:surgery; D014463:Ultrasonography
D015415:Biomarkers; D000469:Alkaline Phosphatase; D001663:Bilirubin