International Surgery Journal | August 2019 | Vol 6 | Issue 8 Page 2670 International Surgery Journal Elghamry EE et al. Int Surg J. 2019 Aug;6(8):2670-2676 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Evaluation of different methods of laparoscopic treatment of common bile duct stones Elghamry E. Elghamry*, Mohamed M. Elsheikh, Hamdy A. Mohamed INTRODUCTION The incidence of gallbladder stones in adults ranges from 6% to 10%. 1 Choledocholithiasis occurs in about 10% to 15% of patients with gall bladder stones and can lead to a lot of complications, such as obstructive jaundice, biliary colic, cholangitis and pancreatitis. 2 After worldwide acceptance of laparoscopic cholecystectomy as the gold standard for the management of gallbladder stone disease, extension of the benefits of the laparoscopic approach to the treatment of common bile duct stones becomes the logical next step. 3 The best management of patients with common bile duct stones has always been challenging, and it remains controversial. 4 Progress in endoscopic technology and equipment and improvement in laparoscopic expertise established the principal minimally invasive techniques. 5 However, managing CBD stones remains controversial, with the debate between a single-stage procedure in the form of laparoscopic common bile duct exploration (LCBDE) with cholecystectomy and two-stage procedure using endoscopic retrograde cholangio pancreatography ABSTRACT Background: Common bile duct (CBD) stones are the second most common complication of gall bladder stones. The best management of patients with CBD stones remains controversial. The aim of this study was to evaluate the methods of laparoscopic CBD exploration (LCBDE). Methods: This prospective study was conducted on 30 patients with CBD stones through 2 years. CBD stricture was excluded. Authors used transcystic and transcholedochotomy approaches for LCBDE either with or without choledoschope. Primary repair of the choledochotomy incision was done. Results: The mean age was 48.90±11.84 years. Biliary colic was the presentation in 63.3% of patients. The transcystic approach for CBD exploration was used in 16 cases without conversion, 11 cases were completed without choledochoscope, while 5 cases with choledochoscopic guided extraction. Choledochotomy approach had been used in 13 cases, 6 cases were completed with choledochoscope and 7 cases without it, two cases of them failed. One case failed from the beginning and was converted to open exploration. 5 ERCP previously inserted stents were removed. The mean operative time was 162.33±74.67 min. Bile leakage occurred in 2 cases following the choledochotomy approach. The mean hospital stay was 3.371.38 days. Conclusion: LCBDE is a feasible, effective and safe approach to bile duct stones. Depending on proper training and gaining experience. Keywords: Choledocoscope, Choledochotomy, Common bile duct stone, Laparoscopic common bile duct stone exploration Department of General Surgery, Faculty of Medicine, Tanta University, Egypt Received: 15 May 2019 Revised: 20 June 2019 Accepted: 29 June 2019 *Correspondence: Dr. Elghamry E. Elghamry, E-mail: elghamry2@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20193306