caa a22 4500 475780019 CHVBK 20180406123641.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/PL00021297 doi (NATIONALLICENCE)springer-10.1007/PL00021297 Endoscopic retrograde cholangiopancreatography in the management of choledocholithiasis [Elektronische Daten] [A. E. Park, Jr., M. J. Mastrangelo] Abstract.: Surgeons today have a wide range of therapeutic options for the management of patients with choledocholithiasis. Endoscopists, interventional radiologists, and surgeons employ a variety of techniques to access and remove common bile duct stones (CBDS) successfully. Although earlier studies have been done to assess the relative merits of laparoscopic and endoscopic management of CBDS, few of them have employed a randomized prospective trial for the comparison. Without recognized parameters for comparison, no definitive conclusions can be drawn. Herein, we examine the role of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) as an important adjunct to laparoscopic cholecystectomy (LC) in the management of CBDS. The three main scenarios in which this modality is employed for CBDS removal are selective preoperative ERCP, intraoperative ERCP, and postoperative ERCP. We conclude that an appropriate balance must be struck to maintain a high yield of positive or therapeutic ERCP, avoid unnecessary ERCP, and not miss CBDS, while ensuring acceptably low rates of morbidity and mortality and controlling costs. As we await the publication of prospective data, we may look for direction from decision analysis in order to develop optimal management strategies and define the 's'sbest practice'' results that should be expected of operators before new procedures and innovative technology are accepted on a widespread basis. Springer-Verlag New York Inc., 2000 Key words: Choledocholithias — Common bile duct stones — Endoscopic retrograde cholangiopancreatography — ERCP — Gallbladder — Laparoscopic common bile duct exploration nationallicence Park A. E. Department of Surgery, Division of General Surgery, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536-0298, USA, USA aut Mastrangelo Jr., M. J. Department of Surgery, Division of General Surgery, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536-0298, USA, USA aut Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 219-226 0930-2794 14:3<219 2000 14 464 https://doi.org/10.1007/PL00021297 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/PL00021297 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Park A. E. Department of Surgery, Division of General Surgery, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536-0298, USA, USA aut NATIONALLICENCE 700 1- Mastrangelo Jr., M. J. Department of Surgery, Division of General Surgery, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536-0298, USA, USA aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 219-226 0930-2794 14:3<219 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer