Management Cholestasis Due to Choledocal Lithiasis

Background: The management of common bile duct stones still remains an area of controversy. Over the years, numerous authors have proposed various solutions: based on the time of cholecystectomy treatment can be preoperatively or intra and post-operative (in singlestage and two-stage). Methods: We have selected and compared several studies that make a compare between one-stage management [Laparoscopic Cholecystectomy (LC) Plus Laparoscopic Common Bile Duct Exploration (LCBDE) or Intra-Operative ERCP) and two-stage management [laparoscopic cholecystectomy preceded or followed by Endoscopic Retrograde Cholangio Pancreatography (ERCP)] in secondary choledocholithiasis, adding our personal experience in two stage management of CBDS. Results: In accordance with relevant randomized trials, we can say that the clinical outcome after one-stage laparoscopic/endoscopic management of bile duct stones is no different to the outcome after two-stage management. Conclusion: Our evaluations indicate that the best treatment of choice for any patient with CBDS must be based on locally available expertise, experience of the multidisciplinary team and standardization of the technique (endoscopic, laparoscopic and surgical), as determined by success rates, rates of morbidity and mortality, costs, and patient preference.