Choledocholithiasis remains a common and clinically significant condition encountered in general and hepatobiliary surgery. The evolution of minimally invasive techniques has transformed its management, shifting practice from traditional open exploration and staged endoscopic–surgical approaches toward single-stage laparoscopic strategies. This manuscript provides a comprehensive review and synthesis of contemporary evidence on the laparoscopic management of common bile duct stones, with particular emphasis on single-stage laparoscopic common bile duct exploration (LCBDE). Drawing upon retrospective cohort studies, long-term institutional experiences, and comparative analyses, this article evaluates indications, technical approaches, outcomes, and limitations associated with modern laparoscopic techniques. Topics explored include patient selection, transcystic versus choledochotomy approaches, primary closure versus T-tube drainage, adjunctive technologies such as pneumatic lithotripsy and self-expanding metal stents, and training considerations for safe implementation. Outcomes including stone clearance rates, morbidity, length of hospital stay, and resource utilization are discussed in detail. The review highlights areas of consensus as well as persistent controversies, particularly regarding optimal closure techniques and the learning curve associated with advanced laparoscopic biliary surgery. By integrating available evidence and identifying existing gaps, this manuscript aims to support informed clinical decision-making and guide future research in the management of choledocholithiasis.

Choledocholithiasis, laparoscopic common bile duct exploration, biliary lithiasis, minimally invasive surgery, single-stage management, biliary drainage

1. Z. Jinfeng, Y. Yin, Z. Chi, G. Junye, Management of impacted common bile duct stones during a laparoscopic procedure: a retrospective cohort study of 377 consecutive patients, International Journal of Surgery 32 (2016) 1–5.

2. G. Tarantino, P. Magistri, R. Ballarin, G. Assirati, A.D. Cataldo, F.D. Benedetto, Surgery in biliary lithiasis: from the traditional open approach to laparoscopy and the rendezvous technique, Hepatobiliary and Pancreatic Diseases International 16 (2017) 595–601.

3. K. Hartery, C.S. Lee, G.A. Doherty, F.E. Murray, G. Cullen, S.E. Patchett, et al., Covered self-expanding metal stents for the management of common bile duct stones, Gastrointestinal Endoscopy 85 (2017) 181–186.

4. S. Quaresima, A. Balla, M. Guerrieri, R. Campagnacci, E. Lezoche, A.M. Paganini, A 23-year experience with laparoscopic common bile duct exploration, HPB 19 (2017) 29–35.

5. S.J.F. Qadri, M. Khan, N. Khan, Use of pneumatic lithotripsy for managing difficult common bile duct calculi, International Journal of Surgery 9 (2011) 59–62.

6. B. Schwab, E.N. Teitelbaum, J.H. Barsuk, N.J. Soper, E.S. Hungness, Single-stage laparoscopic management of choledocholithiasis: an analysis after implementation of a mastery learning resident curriculum, Surgery 163 (2018) 503–508.

7. R.J. Rosenthal, R.L. Rossi, R.F. Martin, Options and strategies for the management of choledocholithiasis, World Journal of Surgery 22 (1998) 1125–1132.

8. X. Zhan, Y. Wang, J. Zhu, X. Lin, Laparoscopic choledocholithotomy with a novel articulating forceps, Surgical Innovation 23 (2016) 124–129.

9. E.S. Hungness, N.J. Soper, Management of common bile duct stones, Journal of Gastrointestinal Surgery 10 (2006) 612–619.

10. J.E. Verbesey, D.H. Birkett, Common bile duct exploration for choledocholithiasis, Surgical Clinics of North America 88 (2008) 1315–1328.

11. Q.D. Zhu, C.L. Tao, M.T. Zhou, Z.P. Yu, H.Q. Shi, Q.Y. Zhang, Primary closure versus T-tube drainage after common bile duct exploration for choledocholithiasis, Langenbeck’s Archives of Surgery 396 (2011) 53–62.