Common bile duct stones

Abstract

Previously, when a surgeon diagnosed bile duct lithiasis, he/she performed cholecystectomy, choledocotomy, stone removal and placement of a Kehr’s “T” tube. Some cases might require sphincteroplasty or bilio-digestive bypass. Nowadays, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, endoscopic ultrasound and intraoperative ultrasound have
emerged as diagnostic and therapeutic tools. Decision-making processes are complex and there is no conclusive evidence supporting them. Many studies have focused on the matter with a non-comprehensive approach so that each surgeon will use his/her common sense for each individual case.
The optimal management of the common bile duct is still controversial. Deciding on endoscopic, laparoscopic or conventional management requires adequate training and clinical judgment. Conventional surgery is still in valid option.