ERCP - ES BEFORE VLC 3 PTS INTRAOPERATIVE EXTRACTION 1 PT ERCP - ES AFTER VLC TABLE II - Complications 1 PT BILIARY LEAK

Choledocholithiasis is a problem of remarkable clinical importance, as demonstrated by its incidence, clinical manifestations, and outcomes with sometimes severe complications; nevertheless, great variabilities still exist in the diagnostic and therapeutic distances 1. 10% of the female population and 6% of the male population are affected by cholelithiasis. We know that the lithiasis of the common bile duct (CBD) is associated with gallstones in 10-20 % of patients, with the percentage of association between 8% and 15% in patients under the age of 60 and between 15% and 60% in patients over the age of 60 2. Choledocholithiasis figures most commonly like a complication of gallstones, due to stones moving to the cystic duct from the gallbladder. Choledocholithiasis is a significant source of morbidity, and an optimal program of treatment must preview their identification and removal (pre-, intra-, or postoperatively). In our geographic area, lithiasis of the gallbladder is mostly due to the formation of cholesterol stones 1. We define symptomatic patients as those for whom the cholelithiasis has caused or causes biliary pain (a severe pain in the right hypochondrium or in the epigastric area of a duration of at least half an hour) or complications directly associated with the lithiasis (cholestatic jaundice, acute pancreatitis, or acute cholePervenuto in Redazione Novembre 2010. Accettato per la pubblicazione Dicembre 2010. Correspondence to: Paolo Del Rio M. D. , University of Parma, School of Medicine, Department of Surgical Science, General Surgery and Organ Transplantation (e-mail: paolo. delrio@unipr. it) Paolo Del Rio, Paolo Dell’Abate, Domenico Labonia, Marco Negri, Nicoletta Sianesi, Maria Francesca Arcuri, Mario Sianesi