The standard treatment for patients with symptomatic gallstones is laparoscopic cholecystectomy (LC). In patients undergoing LC the prevalence of common bile duct (CBD) stones ranges between 8% and 15% and it increases with advancing age, reaching up to 60% in elderly patients. Every patient who is candidate for LC should be evaluated for the presence of CBD stones and these should be treated if the diagnosis is confirmed. In the literature, the procedure of choice for CBD stones treatment is still debated. In many centers, pre- or postoperative endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) and LC (two-stage endo-laparoscopic management) is considered standard practice instead of open choledocholithotomy and cholecystectomy.
