Sequential treatment of the common bile duct stones and cholecystolithiasis.

The orthodox method of the treatment of gallstone disease is laparoscopic cholecystectomy (LC) days or weeks after endoscopic retrograde cholangiopancreatography + endoscopic spincterotomy (ERCP+ES). It can be advantageous from the point of financing, that is double reimbursement (2 x DRG). On the other hand there are some disadvantages of this procedure: longer hospital stay, further suffering of the patient, difficulties at operation because of inflammation provoked by ERCP (11% 14/120 in 3 month). We report on our experience with the treatment of common bile duct stones within 24 h by sequential endoscopic-laparoscopic management. The gallstone disease of a 32 year old woman was diagnosed by ultrasonography and laboratory tests. She had ERCP+ES in the morning and LC 7 hours later. There was no complication and the patient was discharged already on the 3rd day.