Laparoscopically guided cholecystectomies have been performed routinely  at the Hospital of the University of Pennsylvania since 1990. Virtually all patients with symptomatic gallstones are now candidates for the procedure. Referred patients are evaluated by skilled gastrointestinal surgeons with expertise in minimally invasive procedures. Individuals suspected of harboring choledocholithiasis are referred to the gastrointestinal interventionist for preoperative retrograde cholangiopancreotography. Preoperative ERCP is generally coordinated within 24 hours of the laparoscopic cholecystectomy.
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