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Subjects: Evaluation the results of laparoscopic choledochotomies in management of principal bile duct stones. Methods: Retrospective; all patients have principal bile duct stones, was diagnosed by clinical examination, twice ultrasound with experienced doctors and underwent laparoscopic choledochotomy (with or without flexible bile ducts endoscopic and electrohydraulic) at Hue Central Hospital from 2000 to 2012. Results: Total 186 common bile duct stones patients underwent laparoscopic choledochotomies (71 cases applied flexible bile ducts endoscopic and electrohydraulic). Indications: 1) Concommitant gallstones and common bile duct stones, 2) Previously failed endoscopic extraction, 3) Large (>2 cm) or multiple common bile duct stones, 4) Diametter of common bile duct > 10mm in twice ultrasounds. Mean age 53 (22-83), male/female: 79/107, mean operative time: 130 minutes (90-230), intraoperative complications 4.3% (8/186), open conversion: 10.21% (19/186). Complete stone clearance was achieved in 94.61 (158/167) patients. Postoperative complications: 9.58 (16/167). Hospitalization days: 7.6 (5-17). Long-term outcome: 88.6% (148/167) patients returned (7 cases have common bile duct stones, 2 cases pancreatitis and two obstructed the distal end of common bile duct). Conclusions: Management principal bile duct stones by laparoscopic choledochotomies is safe and effectively with high complete stones clearence, low intraoperative and postoperative complications. This procedure can apply to historical upper laparotomy and better effect if it concommitant with flexible bile ducts endoscopy and electrohydraulic.

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