[Current management of uncomplicated gallstones and choledocolithiasis].
In case of clinical suspicion of symptomatic bile duct stones, percutaneous ultrasonography and liver function tests should be performed as a primary evaluation. In the absence of predictive factors of common bile duct stones, laparoscopic cholecystectomy represents the treatment of choice for symptomatic gallstones. In case of clinical, radiological or biochemical suspicion of common bile duct stones, endoultrasonography or magnetic resonance cholangiography are efficient to confirm choledocolithiasis. In this instance, surgical approach permits simultaneous treatment of both choledocolithiasis and cholecystolithiasis while endoscopic sphincterotomy has to be followed by secondary cholecystectomy in a 2-stage procedure. Laparoscopic common bile duct exploration should be preferred to endoscopic clearance of the common bile duct but requires specific equipment and surgical experience.
Mabrut
Jean-Yves
JY
Service de chirurgie générale digestive et de la transplantation hépatique, hôpital de la Croix-Rousse, 69317 Lyon Cedex 04. jean-yves.mabrut@chu-lyon.fr
Ducerf
Christian
C
Baulieux
Jacques
J
D000465:Algorithms; D042883:Choledocholithiasis / Q000175:diagnosis* / Q000628:therapy*; D042882:Gallstones / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans