Laparoscopic Transcystic Duct Choledochoscopy

LCBDE offers a minimally invasive approach for CBD stones in a single procedure. For approximately 80% of patients with CBD stones, the transcystic approach is appropriate and feasible. The success rate for clearing the duct using the transcystic approach is 75% to 95%, the morbidity and mortality rates are low, and the recovery is similar to that for laparoscopic cholecystectomy alone.2,4,7,9,10,13,21,24 Performing LCBDE does require some additional skills of the surgeon and the team as well as additional equipment and instuments. Therefore, many surgeons performing laparoscopic cholecystectomy are reluctant and uncomfortable performing LCBDE and rely on pre- or postoperative endoscopic stone removal. However, clearing the CBD of stones with a single procedure and a single anaesthetic is clearly easier for the patient and has been shown to be cost-effective.6,8,9,11,15