title: [Laparoscopic treatment of common bile duct lithiasis associated with gallbladder lithiasis].
abstract: BACKGROUND
  Laparoscopic bile duct exploration has become one of the main options for the treatment of choledocholithiasis associated with cholelithiasis. Our objective is to describe the results of a consecutive series of patients.
  
  
  METHODS
  We retrospectively analyzed 101 (66 female/16 male) patients who underwent laparoscopic bile duct exploration. Age was 58 +/- 18 years. We analyzed operaion time, hospital stay and postoperative complications according to the surgical approach (transcystic or choledochotomy). Clinical follow up was carried out for 90 days after surgery and then subsequently by telephone.
  
  
  RESULTS
  1435 laparoscopic cholecystectomies were performed between January 1998 and December 2005. Of those, 101 of those patients underwent laparoscopic bile duct exploration for cholelithiasis and common bile duct stones. We evaluated clinical, laboratory and ultrasound predictors: 70 patients had positive and 31 negative predictors. Laparoscopic transcystic approach was successful in 78 patients and laparoscopic choledochotomy in 17 patients. Operation time was 154 +/- 59 minutes and hospital stay 4.31 +/- 3.44 days. Six patients (5.9%) were converted to open surgery. Two patients were re-operated for postoperative bile leakage. The overall effectiveness was 94%. Postoperative mortality was 0.99%. Median follow up was 51 months. Three patients died of unrelated conditions, three underwent ERCP and one had transfistular extraction for retained stones (3.96%).
  
  
  CONCLUSIONS
  Laparoscopic treatment for common bile duct stones associated with gallbladder stones is a highly effective procedure with a low incidence of retained stones.
authors.affiliation: Sección de Hígado, Vías Biliares y Páncreas, Servicio de Cirugía General. Hospital Alemán, Buenos Aires, Argentina. alexmandry@hotmail.com
authors.forename: Alexandra Catalina
authors.initials: AC
authors.lastname: Mandry
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Bun
authors.forename: María Laura
authors.initials: ML
authors.lastname: Ued
authors.forename: Mario Luis
authors.initials: ML
authors.lastname: Iovaldi
authors.forename: Pablo
authors.initials: P
authors.lastname: Capitanich
mesh_terms: D000328:Adult; D000368:Aged; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D042883:Choledocholithiasis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002769:Cholelithiasis / Q000150:complications* / Q000601:surgery; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors