LEFT LATERAL LAPAROSCOPIC CHOLECYSTECTOMY AND ITS RELEVANCE TO CHOLEDOCHOLITHIASIS

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Abstract
One of the current challenges to the laparoscopic biliary surgeon is the management of bile duct stones. While laparoscopic bile duct exploration is in its infancy, pre- and postoperative endoscopic retrograde cholangiopancreatography with or without endoscopic papillotomy (ERCP/EP) currently plays a significant role. Intra-operative ERCP/EP has advantages over pre- and postoperative ERCP/EP; however it has not gained popularity due, partly, to the difficulties associated with ERCP/EP being performed with the patient in the supine position. This study prospectively assessed, in 10 consecutive patients, the feasibility of performing laparoscopic cholecystectomies in the left lateral position, a position amenable to intra-operative ERCP/EP if necessary. It is concluded that laparoscopic cholecystectomy in the left lateral position can be performed safely, with similar ease and results as in the supine position, increasing the options available to manage choledocholithiasis.