TY - CHAP M1 - Book, Section TI - Common Bile Duct Exploration A1 - Hunter, John G. A1 - Spight, Donn H. A1 - Sandone, Corinne A1 - Fairman, Jennifer E. PY - 2018 T2 - Atlas of Minimally Invasive Surgical Operations AB - Laparoscopic common bile duct (CBD) exploration (LCBDE) is indicated for all patients with known CBD stones at the time of laparoscopic cholecystectomy, but is most commonly used when an intraoperative cholangiogram or ultrasound exam demonstrates one or more filling defects in the CBD, presumed to be CBD stones. Following cholecystectomy, most CBD stones are addressed with endoscopic retrograde cholangiography and endoscopic sphincterotomy (ERC/ES) rather than LCBDE. Additionally, in the presence of acute cholangitis or acute pancreatitis from choledocholithiasis, ERC/ES has proven to be a safer strategy that open CBDE. Although no studies have randomized patients with acute cholangitis to LCBDE or ERC/ES, the benefits of urgent bile duct decompression can usually be achieved with an ERC/ES, followed by laparoscopic cholecystectomy (if not already performed) at a later date, when the acute illness has resolved. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1162530881 ER -