الفهرس 
Historical perspectiveOnly 14 pages are availabe for public view
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Abstract
CBD stones is one of the relatively common conditions faced by surgeons due to the high incidence of gallbladder stones that is considered its primary cause. It carries a potentially fatal complications such as acute cholangitis, acute pancreatitis, and even septic shock. These facts should warrant surgeons to manage CBD stones as early as possible. Early management depends on early diagnosis. Wide spectrum of diagnostic tools are available nowadays, surgeons should choose the ordered investigations based on many factors such as: specificty, sensetivity, availability, cost, and safty.
After diagnosis there are three major pathways for treatment; laparoscopic, endoscopic, and open surgical approach. These pathways are intersecting at many point as a compination of two of them can be used for the benefit of the pateint. The most frequently used compination is laparoscopic cholecystectomy and ERCP, either preoperative, intraoperative or postoperative.
Many factors affect the choice of the approach that to be used. The most important factor is patient safty. Regarding this, local equipment and expertise play a great role specially in more demanding approach such as laparoscopic approach, and to lesser extent, the ERCP. So litrature does not offer a single pathway for treatment, as treatment options should be tailored according to the patient’s condition, and medical facility in which he is treated level of experince.