[Treatment of cholecysto-choledocholithiasis in the present era of minimally invasive laparoscopic surgery].

The authors try to contribute to the solution of the problem of cholecystolithiasis associated with choledocholithiasis. Nowadays in the era when choledochilithiasis is treated by low-invasion methods the solution has a different character. The majority of gallstones is symptomatic, their verification and removal by the endoscopic route is not associated with major problems. Concrements not detected during the perioperative period and not detected by diagnostic methods may cause various postoperative difficulties. The authors' experience is based on 302 laparoscopic cholecystectomies performed in the course of 14 months. They made cholangiographic examinations in 54 of the operated patients. This number comprised 21 where the examination was made before the operation, 18 during the operation and in 5 it was made during the postoperative period. In 20 patients (37.03%) the cholangiographic finding was positive. Due to intensive collaboration with the endoscopic centre, when using the method of therapeutic splitting und per operative cholangiography in indicated cases, they were able to reduce the risk of missed concrements to 0.33%.