2011 Volume 25 Issue 2 Pages 183-188
Therapeutic strategies for cholecystocholedocholithiasis without acute cholangitis are indicated in both Guidelines for the surgical treatment using endoscopic surgery and Guidelines for the management of cholecystocholedocholithiasis. A combination therapy of laparoscopic cholecystectomy and choledocholithotomy is recommended in the former GLs, and a combination therapy of endoscopic transpapillary endoscopic choledocholithotomy and laparoscopic cholecystectomy is recommended in the latter GLs. Both combination therapies are performed by an expert doctor, and are supported by the evidences. Results of biennially questionnaires from 1990 by Japan Society for endoscopic surgery indicate that a combination therapy of endoscopic transpapillary endoscopic choledocholithotomy and laparoscopic cholecystectomy become majority year by year. On the other hand, Forty-two percentage of hospitals which answered to a questionnaire in 2009 performed open surgery for patients with cholecystocholedocholithiasis. This open surgery is still important therapy clinically. Therefore, those two combination therapies recommended in each of GLs and open surgery are standard therapy for patients with cholecystocholedocholithiasis without acute cholangitis in the present.
