A history of the dissolution of retained choledocholithiasis.
BACKGROUND
Common duct calculi retained after gallbladder surgery continue to present a clinical challenge especially in the era of minimally invasive surgery. This review examines the strategy of dissolution therapy used throughout the history of biliary tract surgery and its use to the modern surgeon.


METHODS
Original journal articles and reviews were identified using standard surgical textbooks and MEDLINE. Keywords for searching included choledocholithiasis, dissolution, mono-octanoin, common duct stones, MTBE, cholic acid, and gallstones.


CONCLUSIONS
Dissolution therapy used initially as an alternative to open surgery is now used more effectively as an adjunct to laparoscopic or endoscopic biliary tract surgery. The current review demonstrates a majority of patients with retained choledocholithiasis respond to dissolution and can be safely managed without choledochotomy.
Kelly
E
E
Department of Surgery, University of California, Davis-East Bay, Oakland, California, USA.
Williams
J D
JD
Organ
C H
CH
D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage; D001647:Bile Acids and Salts / Q000008:administration & dosage; D002118:Calcium / Q000008:administration & dosage; D002210:Caprylates; D002614:Chelating Agents / Q000008:administration & dosage; D002725:Chloroform / Q000008:administration & dosage; D017081:Cholecystectomy, Laparoscopic; D005100:Expectorants / Q000008:administration & dosage; D042882:Gallstones / Q000628:therapy*; D005989:Glycerides / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008738:Methyl Ethers / Q000008:administration & dosage; D012965:Sodium Chloride; D012995:Solubility; D012997:Solvents / Q000008:administration & dosage; D007507:Therapeutic Irrigation
D000779:Anesthetics, Local; D001647:Bile Acids and Salts; D002210:Caprylates; D002614:Chelating Agents; D005100:Expectorants; D005989:Glycerides; D008738:Methyl Ethers; D012997:Solvents; C043243:methyl tert-butyl ether; D012965:Sodium Chloride; D002725:Chloroform; D006493:Heparin; D002118:Calcium; C025343:monooctanoin