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Abstract An analysis of the results of our present study and a review of the literature shows that laparoscopic exploration of the common bile duct is a feasible, safe and effective approach that carries a low morbidity and mortality for management of choledocholithiasis. The development of instrumentations and techniques increased the interest in learning these new laparoscopic skills and allowed the procedure to be performed safely. The weight of the evidence also suggested a revised role of endoscopic retrograde cholangiopancreatography (ERCP), which has been questioned because of its cost, risk of complications and effectiveness. Many surgeons are still unfamiliar with these techniques and the benefits of the one-session approach. However, we estimate that LCBDE will become widely used in patients with choledocholithiasis, especially with appropriate training and motivation. In our present study we found that the IOC success rate was up to 100%. Laparoscopic cholecystectomy with routine application of IOC can be performed with safety and with no significant increase in operative time, costs and incidence of retained stones. Routine IOC also permitted us to avoid unnecessary preoperative ERCP in patients with suspected common bile duct stones as reflected in our practice. There are two different methods of LCBDE: A. The transcystic approach (TCE). B. The choledochotomy approach (Transductal approach) (CBDE). |