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Minerva Chirurgica 1999 May;54(5):299-304

language: Italian

Common bile duct calculi. Endolaparoscopic treatment

Vadalà G., Santonocito G., Salice M., Castorina R., Caragliano P.


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Background and aim. Common bile duct calculosis is a pathology which has always been treated using traditional laparotomic surgery. The introduction of endoscopic papillosphincterotomy and mini-invasive and videolaparoscopic methods has drawn attention to the fact that these methods may be able to replace conventional surgery.
Methods. The authors examine the epidemiological and clinical aspects of common bile duct calculosis, reporting their experience in ten female patients treated during the period from 1992 to 1997, all of whom presented jaundice, pain and fever. Of these, eight underwent papillosphincterotomy using an endoscopic approach, followed by laparoscopic removal of common bile duct calculi within 24 hours. In two cases it was necessary to resort to conventional methods owing to difficulty in cannulating the papilla caused by a diverticulum in one patient and stenosis in the other, and the tenacious synechiae between the common bile duct and the gallbladder.
Results. The postoperative period was free of complications.
Conclusions. The associated treatment, namely endoscopic papillosphincterotomy and endoscopic cholecystectomy proved a valid alternative to traditional laparotomic treatment, demonstrating a good level of reliability and safety for patients and reductions in terms of resources and hospitalisation time.

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