The advent of laparoscopy represented a paradigm shift in the management of cholelithiais [1]. However progress with management of choledocolithiasis has proven to be more elusive and remains a challenge for most pediatric units. Jessica Ruah, et al., present their experience with trans-cystic CBD stone extraction, negating the requirement for subsequent or preceding ERCP in most cases, thus avoiding repeat anesthetics [2]. A failure rate of 14% is sited and the fallback option for these cases is an ERCP at a subsequent admission [2].
