title: Laparoscopic choledochotomy in management of choledocholithiasis.
abstract: OBJECTIVE
  Laparoscopic choledochotomy on patients indicated for common bile duct exploration was carried out according to an algorithm for managing choledocholithiasis. This study describes retrospectively our method and evaluates a new cystic duct biliary decompression cannula (J-tube) as an alternative to the T-tube.
  
  
  METHODS
  Patients with confirmed choledocholithiasis (n=46) underwent laparoscopic choledochotomy. The T-tube was inserted in cases with suspected retained stones after common bile duct clearance, and the J-tube (950-mm long, 4 Fr) with a tapered and J-shaped segment at the distal end was inserted in other cases.
  
  
  RESULTS
  Only 1 case was converted to open surgery (success rate, 97.8%); the J-tube was inserted in 30 patients and the T-tube in 15. The median operation time, hospital stay, and the interval until removal of the tube were significantly shorter with J-tube than with T-tube cases. Bile leakage after surgery occurred in 4 J-tube and 2 T-tube cases with one residual stone in each case.
  
  
  CONCLUSIONS
  The transcystic decompression tube is easily and safely inserted with the J-kit. Among several strategies currently available for the management of choledocholithiasis, laparoscopic choledochotomy with the use of the J-tube is one of the safest and most feasible methods.
authors: Division of Surgery, Kobe Rosai Hospital, Kobe, Japan. kanamaru@kobeh.rofuku.go.jp
authors: Taichi
authors: T
authors: Kanamaru
authors: Kazuya
authors: K
authors: Sakata
authors: Yoichiro
authors: Y
authors: Nakamura
authors: Masahiro
authors: M
authors: Yamamoto
authors: Nozomi
authors: N
authors: Ueno
authors: Yoshifumi
authors: Y
authors: Takeyama
mesh_terms: D000465:Algorithms; D042883:Choledocholithiasis / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D012189:Retrospective Studies