[Strategies for endoscopic and surgical treatment of biliary tract calculi].
BACKGROUND
Common bile duct calculi represent a pathologic entity involving obstructive icterus, cholangitis, hepatic cirrhosis or pancreatitits. Common bile duct calculi mostly have a secondary origin (from gallbladder) in 95% of cases, while primary choledocholithiasis is rare.


METHODS
From surgical aspect, common bile duct calculi can be: 1. Asymptomatic, without manifested symptoms or signs, 2. Mobile, with intermittent biliar obstruction and disobstruction, 3. Fixed, with obstruction and signs of hepato-biliary and/or bilio-pancreatic duct, 4. Transitory, microcalculi which pass through Vater's Papilla by propulsion into duodenum with symptoms.


CONCLUSIONS
Modern biliary surgery includes diagnosis of common bile duct calculi, and if possible preoperative endoscopic (endoluminal) surgery, which is less invasive for patients. If such approach is not possible, it is necessary to perform stone extraction and cholecystectomy.


CONCLUSIONS
Common bile duct calculi represent a common disease of the digestive system. Endoscopic diagnostic procedure is very important in management of choledocholithiasis. Endoscopic treatment of common bile duct calculi prior to cholecystectomy is a method of choice and a strategy for associated cholecysto-choledocholithiasis.
Stojanović
Dragos
D
Klinika za opstu hirurgiju, KBC Dr Dragisa Misović-Dedinje, Beograd. dragoss@Eunet.yu
Stojanović
Mirjana
M
Milojević
Predrag
P
Caparević
Zorica
Z
Lalosević
Dorde
D
Radovanović
Dragan
D
D002769:Cholelithiasis / Q000175:diagnosis / Q000601:surgery*; D004724:Endoscopy; D042882:Gallstones / Q000175:diagnosis / Q000601:surgery*; D006801:Humans