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Choledocholithiasis (intraoperative) — MCCQE Part 1 MCQ

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HardAbdominal PainCholedocholithiasis (intraoperative)MCCQE Part 1

During laparoscopic cholecystectomy, intraoperative cholangiogram shows a CBD filling defect. Cystic duct clipped. Most appropriate next step?

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Correct answer: C — Laparoscopic or open CBD exploration

CBD stone found intraop: laparoscopic CBD exploration if expertise available (single-stage). Alternative: complete chole + postop ERCP within 24-72h (two-stage). Choice depends on surgical expertise.

Reference: Canadian HPB Surgery Guidelines