Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2019; 25(13): 1531-1549
Published online Apr 7, 2019. doi: 10.3748/wjg.v25.i13.1531
Comprehensive and innovative techniques for laparoscopic choledocholithotomy: A surgical guide to successfully accomplish this advanced manipulation
Tomohide Hori
Tomohide Hori, Department of Hepato-Biliary-Pancreatic Surgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
Author contributions: Hori T performed this laparoscopic surgery, reviewed previous papers in this field, and wrote this article; all illustrations and schemas were originally drawn by Hori T.
Conflict-of-interest statement: The author has no potential conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Tomohide Hori, FACS, MD, PhD, Associate Professor, Department of Hepato-Biliary-Pancreatic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoinkawara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Telephone: +81-757513651 Fax: +81-757513106
Received: January 29, 2019
Peer-review started: January 29, 2019
First decision: February 26, 2019
Revised: March 5, 2019
Accepted: March 11, 2019
Article in press: March 12, 2019
Published online: April 7, 2019
Core Tip

Core tip: The right upper quadrant of the abdomen is advantageous for laparoscopic procedures. Laparoscopic choledocholithotomy is safe and feasible, although this laparoscopic approach involves technical difficulties. Endoscopic sphincterotomy destroys the physiological function of Oddi’s sphincter. Laparoscopic choledocholithotomy has excellent clinical outcomes; however, emergent biliary drainage and removal of anesthetic risk factors are required preoperatively. Cholangiographic removal of stones strongly affects operative time. Cholangioscopy has only two-way operation; using dedicated forceps to atraumatically grasp the cholangioscope is important for smart maneuvering.