Sequential treatment of the common bile duct stones and cholecystolithiasis.

The orthodox method of the treatment of gallstone disease is laparoscopic cholecystectomy (LC) days or weeks after endoscopic retrograde cholangiopancreatography + endoscopic spincterotomy (ERCP+ES). It can be advantageous from the point of financing, that is double reimbursement (2 x DRG). On the other hand there are some disadvantages of this procedure: longer hospital stay, further suffering of the patient, difficulties at operation because of inflammation provoked by ERCP (11% 14/120 in 3 month).

[Temporary jejunostomy].

The different techniques used for temporary jejunostomy are described. They are governed by the presence or absence of utilizable stomach. The advantages and drawbacks of each technique are examined.