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Abstract It is worth noting that LCBDE has its drawbacks and limitations being unsuitable for every patient as those with suppurative cholangitis, acute pancreatitis and prolonged severe jaundice for which surgery constitutes high risk procedure and urgent endoscopic drainage is often obligatory. LCBDE is challenged by high surgical experience and availability of fascilities which limits its wide diffusion. Consequently, whenever local resources and expertise are available LCBDE should be offered to fit patients., it should be considered the first choice due to comparable success rate to ERCP with the added advantages of being one session approach and moreover avoiding potential complications of ERCP as acute pancreatitis, sphincter damage. The last to be said is that LCBDE is an excellent choice for patients with common bile duct stones, but it is not the same for those with obstructive jaundice specially if complicated by lifethreatening conditions such as suppurative cholangitis, acute pancreatitis, or severe sepsis or impending liver failure in which surgery may be contraindicated |