RT Book, Section
A1 Ellison, E. Christopher
A1 Zollinger, Jr., Robert M.
A1 Pawlik, Timothy M.
A1 Vaccaro, Patrick S.
A1 Bitans, Marita
A1 Baker, Anthony S.
SR Print(0)
ID 1187822192
T1 Common Bile Duct Exploration, Open
T2 Zollinger’s Atlas of Surgical Operations, 11e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781260440850
LK accesssurgery.mhmedical.com/content.aspx?aid=1187822192
RD 2023/03/31
AB Common  bile  duct  exploration  should  be  performed  in  all  patients  with  common  bile  duct  stones  who  have  either  failed  or  are  not  candidates  for  endoscopic  therapy  and  who  do  not  have  medical  conditions  that  prohibit  surgical  intervention.  Alternative  therapies,  such  as  extracorporeal  shockwave  lithotripsy  and  dissolving  solutions,  are  not  widely  available  and  have  limited  efficacy.  Percutaneous  transhepatic  cholangiography  (PTC),  electrohydraulic  lithotripsy,  and  laser  lithotripsy  may  be  useful  in  a  small  number  of  selected  patients  who  are  not  candidates  for  surgery  or  endoscopic  therapy.  Laparoscopic  common  bile  duct  exploration,  open  common  bile  duct  exploration,  and  postoperative  endoscopic  retrograde  cholangiopancreatography  (ERCP)  with  stone  removal  are  all  options  for  the  treatment  of  common  bile  duct  stones  identified  by  intraoperative  cholangiography,  and  decision  making  should  be  guided  by  patient-specific  considerations,  the  training  and  experience  of  the  surgeon,  and  available  endoscopic  expertise.