[A minimally invasive approach in choledocholithiasis].

In the last years several less aggressive procedures diminished the role of open choledochotomy (CT) in the treatment of common bile duct (CBD) lithiasis. Between them are endoscopic sphincterotomy (EST) and laparoscopic choledochotomy. In a lap of 18 month were followed up, in a prospective way, all the cases of CBD lithiasis admitted in our department. Twenty-seven patients were treated by EST and 28 by CT. The endoscopy was as efficient as open CT in clearing the CBD (85% vs. 83%). Even if the endoscopic group was at a higher risk the morbidity was lower than in the classic approach and the mortality was the same (3.5%). The most common complication after EST was acute pancreatitis (7.5%). The mean hospital stay was lower after EST. Near by are discussed 3 cases of associated gallbladder and CBD lithiasis treated exclusively by laparoscopic approach.