Tratamiento de la colédocolitiasis en un tiempo por videolaparoscopía

At present for the great majority of surgeons, there is no discussion about that laparoscopic cholecystectomy is the therapeutic golden standard for patients with asymptomatic gallbladder lithiasis, however, after 13 years still remain the controversy referred to which is the better approach when there is an associated choledocholithiasis. The aim of the present report was to evaluate prospectively in a consecutive series of patients, the results obtained with the treatment of choledocholithiasis in a single stage management by videolaparoscopy. From 1996 through 2002, we have treated 561 patients at Division General of General Surgery "Cosme Argerich Hospital" Buenos Aires. Of these, 116 cholecystomized patients with common bile duct stones, and 29 patients with acute severe cholangitis, were treated endospically. The remaining 416 patients were treated initially by laparoscopic means in a single stage management. In the article the authors describe the laparoscoscopic transcystic route, indications and surgical technique of laparoscopic choledochotomy, and both transcystic route and choledochotomy. A cholecystectomy for biliary lithiasis should not be considered complete without the complement of the exploration of the common bile duct and it can be explored in several ways. The operative cholangiography procedure extended throughout the world, is now unusual for a surgical center not to perform cholangiography: operative cholangiography is optimal when it is performed as a systematic practice in every patient with calculi in the common bile duct.