Instrumentation and techniques for laparoscopic common bile duct exploration.

The surgical management of biliary stone disease has long since included ERCP and endoscopic sphincterotomy (ES) for the diagnosis and treatment of common bile duct (CBD) stones. Indications to ERCP/ES have progressively expanded from the diagnosis and treatment of retained CBD stones after cholecystectomy to the management of severe cholangitis and acute pancreatitis in high-risk patients to the treatment of all patients with gallstones and CBD stones as part of an integrated endosurgical sequential approach.