Table 2.

Pros and cons of individual surgical technique

Technique	Pro	Con
Cholecystectomy with bile duct exploration and T-tube drainage	• Technically simple	• Requires skills seldom taught to surgical residents
	• Can be performed using open and laparoscopic access (in skilled hands)	• Requires multiple biliary tools and instruments
	• Effective when stone-related inflammation is acute	• Ineffective with chronic strictures
Transduodenal sphincteroplasty	• Used when ERCP ineffective or ampulla inaccessible	• Requires skills seldom taught to surgical residents
		• Limited indications
Choledochoduodenostomy	• Simple technique for direct widely patent biliary drainage	• Requires skills seldom taught to surgical residents
	• Effective for chronic distal benign strictures or impacted stones	• Limited indications
Roux-en-Y hepaticojejunostomy	• Best understood and taught surgical procedure	• Most complex reconstruction
	• Effective and versatile	• Requires division and reconstruction of jejunum
	• Broad indications