This book provides a concise overview of several critically important techniques and their applications within Laparoscopic Common Bile Duct Exploration (LCBDE).  LCBDE is rapidly emerging as the preferential management option for treating patients with common bile duct (CBD) stones. Chapters within this book describe how this technique can be applied to manage patients with concomitant gallstones, which aims to increase the exploration of the CBD via the transcystic route. Particular mention is made for the use of energy devices to enable stone fragmentation within the bile duct also known as Lithotripsy-Assisted Bile duct Exploration by Laparoendoscopy (LABEL). Guidance is also provided on how to set-up an acute biliary service which can offer the single-stage management of concomitant gallstones and choledocholithiasis. The concepts of 'Leveraging Access to Technology and Enhanced Surgical Techniques (LATEST)' in LCBDE and 'Biliary Surgery 2.0' as the framework through whichthese techniques can be further enhanced are analysed.

Laparoscopic Common Bile Duct Exploration features insight into how to perform these increasingly important procedures successfully and set-up a service within institutions that are yet to provide it. Therefore, it is a valuable resource for all medical professionals involved in the care of these patients.

History of biliary surgery.-The first cholecystectomy

The first choledochotomy
History of common bile duct imaging
Technique of CBD exploration in the 60's 70's
The arrival of ERCP
Approach to the cbd stones in the 80's.-The revolution in the nineties: The laparoscopic cholecystectomy and bile duct exploration
Review of the evidence against and in favour of LC-IOC±LCBDE
Our technique & equipment needed
Equipment and kit needed for LCBDE
Surgical technique for LCBDE
Laparoscopic ultrasound
Different surgical scenarios and its specific management
Different surgical scenarios
CBD and CD both non-dilated
CD Dilated & CBD non-dilated
CD non-dilated & CBD Dilated
CD & CBD both dilated
The impossible hilum: The transinfundibular approach
The closure after the access to the CBD
Closure over T -tube
Closure over antegrade stent
Primary closure
Closure with transcystic drain
Bilioenteric anastomoses
The LABEL technique
Our experience with LCBDE in more than 450 cases
The evolution to Biliary Surgery 2.0
Our cases.-Failure to clear the duct
Morbidity
Closure after exploring CBD
T tube vs antegrade stent.-Primary closure
Increase in the use of transcystic approach
The transcystic vs the TD access.-management of Type II Mirizzi syndrome
The impact pf LCBDE in a general surgical department.-Bile duct exploration 2.0 .-Training in LCBDE.