Minimally invasive treatment of cholecysto-choledocal lithiasis: The point of view of the surgical endoscopist

Core Tip

Core tip: Development of Endoscopic Retrograde Cholangiopancreatography and Laparoscopic Surgery have influenced new approaches to the management of cholecysto-choledocal lithiasis. At present available minimally-invasive treatments include: single-stage laparoscopic treatment, perioperative endoscopic treatment and endoscopic treatment alone. Current data does not suggest clear superiority of any one approach with regard to success, mortality, morbidity and cost-effectiveness. Considering the variety of therapeutic options available for management, a critical appraisal and decision-making is required. This should preferably be dictate on the patient, the clinical presentation, the timing of diagnosis (established pre-operative diagnosis or incidental intraoperative diagnosis), the surgical pathology and the local expertise.