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  • Intraoperative on-table endoscopic retrograde cholangiopancreatography (ERCP) is better than laparoscopic bile duct exploration for concomitant bile duct stones during emergency laparoscopic cholecystectomy

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Therapeutics/Prevention
Randomised controlled trial
Intraoperative on-table endoscopic retrograde cholangiopancreatography (ERCP) is better than laparoscopic bile duct exploration for concomitant bile duct stones during emergency laparoscopic cholecystectomy
  1. Pramod Kumar Garg1,
  2. Virinder Kumar Bansal2
  1. 1Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to : Dr Pramod Kumar Garg, Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, Delhi, India; pkgarg{at}aiims.ac.in

https://doi.org/10.1136/ebmed-2016-110549

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    Commentary on: Poh BR, Ho SP, Sritharan M, et al. Randomized clinical trial of intraoperative endoscopic retrograde cholangiopancreatography versus laparoscopic bile duct exploration in patients with choledocholithiasis. Br J Surg 2016;103:1117–24OpenUrl.

    Context

    Some 15% of patients with gallbladder (GB) stones have concomitant stones in the bile duct (BD) believed to have migrated out from the GB. While asymptomatic GB stones may be managed expectantly, BD stones, if detected, require removal even if asymptomatic because of their potential to cause two major complications: acute cholangitis and acute pancreatitis. In patients with concomitant GB and BD stones, open surgery was standard approach but was associated with wound morbidity and T-tube-related problems. With the advent of endoscopic retrograde cholangiopancreatography (ERCP) in the 1970s, endoscopic removal of BD stones gradually received wide acceptance.1 With the …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.