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Tratamiento laparoscópico y endoscópico de la coledocolitiasis. Nuestra experiencia

Keywords: choledocholithiasis, endoscopic retrograde cholangiopancreas tography, endoscopic sphincterotomy, laparoscopic common bileduct exploration.

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Abstract:

choledocholithiasis. current options of the laparoscopic and endoscopic treatment. background: the management of symptomatic or incidental discovered choledocholithiasis is still controversial. from the total of patients under- going elective cholecystectostomy for symptomatic cholelithiasis a 5 to 15% will have a choledocholithiasis. options for treatment include preoperative endoscopic retrograde cholan-giopancreatography (ercp) with sphincterotomy (ercp/es) followed by laparoscopic cholecystostomy with intraoperative cholangiogram(lc/ioc), either followed by laparoscopic common bile duct exploration (lcbde) or intraoperative ercp/es. the aim of present study is to assess the results of the treatment for choledocolithiasis at the national centre for minimal access surgery in havana city. methods: a comprehensive review of literature about present management of choledolithiasis with gall bladder in situ was made and the results of these techniques during a period of 17 years at the national centre for minimal access surgery in havana was also assessed.results: during the period studied 421 patients with symptomatic cholelithiasis and choledocholithiasis were operated by either of the treatment options.there was not significant difference in successful duct clearance between endoscopic and laparoscopic groups. conclusion: all the approaches have similar outcomes. the management of this disease at present depends on each surgical team experience and their access to technological advances.

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