Therapeutisches splitting bei der behandlung der choledocholithiasis

Treatment of common bile duct stones is feasible by surgical exploration (open or laparoscopically) or by endoluminal retrieval (pre-, intra- or postoperatively). The introduction of laparoscopic cholecystectomy greatly stimulated the routine practice of therapeutic splitting with selective endoscopic retrograde cholangiography and, if necessary, stone removal and consecutive cholecystectomy which is currently the usual approach. However, the development of suitable techniques for laparoscopic common bile duct exploration offers again the option to treat gallbladder stones and common bile duct stones in one surgical session. It may be assumed that with increasing improvement of this laparoscopic technique, surgical common bile duct removal will gain greater importance.