[Therapeutic splitting as standard treatment for cholelithiasis]

Chirurg. 2006 Apr;77(4):307-14. doi: 10.1007/s00104-006-1178-3.
[Article in German]

Abstract

At the moment, therapeutic splitting is still regarded by the vast majority of surgeons as the gold standard for stones in the common bile duct. Endoscopic clearance of the duct certainly is much less invasive than open exploration. However, this does not apply when compared with laparoscopic stone removal. Both are equivalent in respect to stone clearance rates, but the laparoscopic techniques protect patients from the long-term sequelae of endoscopic papillotomy. This can be important particularly for younger patients. Laparoscopic bile duct exploration is cost-effective and safe. Special experience in laparoscopic surgical techniques, however, is mandatory. Thus, surgeons should intensify their training in laparoscopic bile duct exploration in order to increase the acceptance of these techniques.

MeSH terms

  • Cholangiography
  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects
  • Cholecystectomy, Laparoscopic*
  • Gallstones / diagnosis
  • Gallstones / surgery*
  • Humans
  • Outcome and Process Assessment, Health Care
  • Postoperative Complications / etiology*
  • Postoperative Complications / prevention & control
  • Postoperative Complications / surgery
  • Reoperation
  • Sphincterotomy, Endoscopic* / adverse effects