Laparoscopic armamentarium for common bile duct stones clearance: tricks and tips

The laparoscopic common bile duct exploration with cholecystectomy (LCBDE + LC) has been shown to be safe and effective for the treatment of choledocolithiasis. However, the use of LCBDE + LC is in decline, as almost replaced by the endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy. Should this trend continue, the laparoscopic approach to choledocholithiasis is at risk of disappearing from the armamentarium of the general surgeons. The aim of this video presentation is to explain the different types of LCBD exploration (transcystic vs transcholedochotomy), when to use them and how to perform them safely and efficiently. Furthermore, the authors explain the intraoperative situations in which a biliary tutor should be placed and how they can be properly managed.