Özet:

Background/aims: Retained choledochal stones after laparoscopic cholecystectomy are still a major problem. The present study investigated the management of retained choledochal stones after laparoscopic cholecystectomy. Materials and methods: Among 226 consecutive patients who underwent laparoscopic cholecystectomy between 1998 and 2004, symptoms, and alanine aminotransferase, aspartate aminotransferase, bilirubin and alkaline phosphatase values of patients with suspected retained choledochal stone were evaluated. Diameter of choledochus was assessed by abdominal ultrasonography. Patients with suspected choledochal stone underwent endoscopic retrograde cholangiography and sphincterotomy. Results: Female to male ratio was 4:1 and median age was 58 years (range, 18-79 years). Elevated alanine aminotransferase values were detected in 16 patients suspected of retained choledochal stone among 23 patients who had been referred to the hospital between 7 days and 2 years following laparoscopic cholecystectomy. Stone extraction was performed in 11 of 12 patients with choledochal diameter of ≥10 mm and with high alanine aminotransferase and bilirubin levels via endoscopic retrograde cholangiography + endoscopic sphincterotomy. Choledochotomy + stone extraction was performed in 1 case via laparotomy. Conclusions: High alanine aminotransferase and choledochal diameter of ≥10 mm are important parameters for determination of choledochal stones, and endoscopic retrograde cholangiography + endoscopic sphincterotomy is a safe and feasible treatment modality.

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