Abstract
Recently, endoscopic management for common bile duct stone is recognized as a standard therapy. But several treatments are needed for each patient, because pathology of each patient is not same and sometimes, plan of treatments between internal medicine and surgery is different. So, standard therapy for common bile duct stone is not only one in current state. There are two methods of laparoscopic choledocholithotomy, i. e. transcystic common bile duct exploration (TCCBDE) and supraduodenal common bile duct exploration (SDCBDE) or choledochotomy. TCCBDE is the best option for CBD stone fell from gallbladder, because transcystic route can be closed only by clips as laparoscopic cholecystectomy, but it's indication is limited. We began laparoscopic treatment for common bile duct stone from 1992, as SDCBDE is always appreciable whenever stones are larger than the diameter of cystic duct, number of stones are many and stones are in the common hepatic duct. We think that SDCBDE is very useful option for CBD stone, but it dose not become popular as there are many difficult procedures i. e. choledochotomy, how to remove stones completely, closure of CBD, drainage of biliary tract. Here, we report our methods of laparoscopic choledochotomy with primary closure of CBD and C tube drainage.
