Premium
THE ROLE OF ERCP AND ENDOSCOPIC SPHINCTEROTOMY IN THE ERA OF LAPAROSCOPIC CHOLECYSTECTOMY
Author(s) -
O'Rourke N. A.,
Askew A. R.,
Cowen A. E.,
Roberts R.,
Fielding G. A.
Publication year - 1993
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1993.tb00024.x
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , bile duct , laparoscopic cholecystectomy , general surgery , cholecystectomy , cholangiography , common bile duct , jaundice , endoscopy , duct (anatomy) , surgery , pancreatitis
The advent of laparoscopic cholecystectomy (LC) has led to some controversy regarding the best method of managing bile duct calculi. This paper reviews the cases of 38 patients who underwent LC and endoscopic retrograde cholangiopancreatography (ERCP), from a series of 600 consecutive laparoscopic cholecystectomies. Twenty‐nine patients had ERCP performed pre‐operatively because of suspicion of choledocholithiasis. Duct stones were confirmed in eight patients. Recent or current jaundice was the best predictor of bile duct stones. Nine patients had ERCP done postoperatively because of duct stones seen on operative cholangiography. In two patients bile duct cannulation was not possible and a third procedure, open duct exploration, was necessary. Techniques in laparoscopic management of duct stones are improving and the role of ERCP and sphinc‐terotomy should be limited to jaundiced patients or those with proven bile duct stones in whom laparoscopic procedures have been unsuccessful.