Single-session minimally invasive management of common bile duct stones

Figure 1 Minimally invasive options for management of cholecysto-choledocholithiasis. LCBDE: Laparoscopic common bile duct exploration; ERCP: Endoscopic retrograde cholangiopancreatography; LC: Laparoscopic cholecystectomy; CBD: Common bile duct.

Figure 2 Technique of combined laparo-endoscopic (Rendez-vous) technique of intraoperative endoscopic retrograde cholangiopancreatography. A: Guidewire passed through the cystic duct opening into common bile duct (CBD) (laparoscopic view); B: Verification of passage of guidewire through the sphincter into the duodenum (fluoroscopic view); C: Guidewire protruding from the papilla and caught with a polypectomy snare (endoscopic view); D: Sphincterotome threaded over the guidewire for sphincterotomy prior to CBD stone extraction.