The last 30 years has seen major developments in the management of gallstone related disease, which in the United States alone costs over 6 billion dollars per annum to treat (1). Endoscopic retrograde cholangio- pancreatography (ERCP) has become a widely available and routine procedure, whilst open cholecystectomy has largely been replaced by a laparoscopic approach, which may or may not include laparoscopic exploration of the common bile duct (LCBDE). In addition new imaging techniques such as Magnetic Resonance imaging (MR) and Endoscopic Ultra-Sound (EUS) offer the opportunity to accurately visualise the biliary system without instrumentation of the ducts. As a consequence clinicians are now faced with a number of potentially valid options for managing patients with suspected CBDS. It is with this in mind that the following guidelines have been written.
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