Abstract
Multiple alternatives have largely superseded open common bile duct (CBD) exploration. Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy provides access to the common duct for extraction of stones and biliary decompression. Laparoscopic transcystic common duct exploration or laparoscopic choledochotomy are alternatives when common duct stones are found at laparoscopic cholecystectomy. Open CBD exploration is still occasionally needed when these methods are not available or fail. The principles of access to the CBD described here are used during the performance of advanced biliary tract surgery and must be thoroughly understood.
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