Management of common bile duct stones: a ten-year experience at a tertiary care center.

BACKGROUND

The authors present their experience with the treatment of cholecystocholedocholithiasis.

METHODS

From August 1995 to August 2005, we treated 3750 patients with symptomatic gallbladder stones, and 12.7% of these patients also had a choledocholithiasis. This percentage with reference to the literature is certainly due to intraoperative cholangiography (IOC) performed routinely. During the follow-up, the percentage of residual versus recurrent stones was evaluated.

RESULTS

Only 2 patients (3.1%) of the laparoscopic choledochotomy and cholecystectomy group had retained stones discovered at 5 and 11 months after surgery. These patients received ERCP with good results. No patients had leaks or fistulas. Only one patient died from a massive pulmonary embolism (1.6%).

CONCLUSION

We believe that the key to successful management of patients with CBD stones is a well-standardized institutional procedural algorithm consistent with the available local resources and technologies.