title: Laparoscopic transduodenal sphincteroplasty.
abstract: BACKGROUND
  Common bile duct stones are a difficult problem, often leading to conversion to an open operation or repeated endoscopic procedures. Both strategies are associated with added morbidity.
  
  
  METHODS
  A new technique was developed to perform a traditional sphincteroplasty using minimally invasive methods. The procedure was performed on two patients with distal common bile duct stones; each patient had previously undergone at least two unsuccessful preoperative endoscopic retrograde cholangiopancreatography procedures by at least two different experienced endoscopists.
  
  
  RESULTS
  In both patients, a laparoscopic transduodenal sphincteroplasty was successfully completed. A transduodenal common bile duct exploration was performed at the time of sphincterotomy, successfully clearing the common bile duct in both cases. There were no untoward postoperative sequelae. Follow-up at one year was satisfactory in both patients.
  
  
  CONCLUSIONS
  Laparoscopic transduodenal sphincteroplasty can be safely performed in patients with common bile duct stones refractory to endoscopic retrograde cholangiopancreatography. This technique offers a new approach to the management of common bile duct stones, and can spare patients the need for an open operation or subsequent endoscopic procedures.
authors.affiliation: Department of Surgery, Georgetown University Medical Center, Washington, D.C., USA.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Makary
authors.forename: Hazem A
authors.initials: HA
authors.lastname: Elariny
mesh_terms: D042882:Gallstones / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D013105:Sphincterotomy, Transduodenal / Q000379:methods*; D016896:Treatment Outcome