Exploración laparoscópica de la vía biliar en pacientes con litiasis vesicular y coledocolitiasis compleja

in order to compare the success of the laparoscopic exploration in patient with complicated choledocholitiasis versus single stage laparoscopic management, we realized a prospective study of 20 patients with indication of laparoscopic common bile duct exploration admitted in the period february 2005 - october 2008. we studied patients in whom the pcre was ineffective versus single stage laparoscopic management. in seven patients (35 %) the indication of the laparoscopic common bile duct exploration was high risk of common bile duct stones and ineffective pcre. the success rate was 57 % versus 84.7 % in the laparoscopic single stage management group. the surgical mean time (187？ vs 106？) and the hospital stay (4.5 vs 2.3 days) were probably related with the higher complexity of these cases. the patients with common bile duct stones in whom the pcre is ineffective, must be considered complex cases. in these patients, the laparoscopic management success is lower with an increase conversion rate.