Future Treatment of Common Bile Duct Stones

Management options for patients found to have common bile duct stones have expanded as a function of improved instrumentation and radiographic support. Technological advances initially lead to increased costs but eventually result in improved quality for patients. Controversy exists for patients with either soft clinical findings or stones found at the time of laparoscopic cholecystectomy. As laparo-scopic common duct exploration becomes more wide-spread the need for perioperative ERCP will likely decrease; however, this will depend on the experience of the sur-geons at a given institution. Common bile duct stones found at the time of laparoscopic cholecystectomy can be approached in a variety of different ways. The most com-monly used methods are laparoscopic transcystic common bile duct exploration, laparoscopic choledochotomy wit