iarjmsIARJMSIARJMS2708-359410.47310/iarjms.2021.v02i02.034Which Technique is better in the Management of Cholelithiasis with Choledocholithiasis: Endoscopic Retrograde Cholangio Pancreaticography or Common Bile Duct Exploration with Primary Closure or T- Tube Drainage? A Critical ReviewDhimanARamBGuptaAKGuptaJKumariSDepartment of Surgery, IGMC Shimla, HP- IndiaProfessor, Department of Surgery, IGMC Shimla, HP- IndiaAssistant Professor, Department of Surgery, IGMC Shimla, HP- IndiaDepartment of Physiology, IGMC Shimla, HP- IndiaThere remains a conflict of opinion in approach to treatment of cholelithiaisis with choledocholithiasis. Available options range from open surgery, endoscopic and laparoscopic exploration. Nowadays intravenous cholangiography has been replaced by magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS) and ERCP. The most direct method of dealing with choledocholithiasis preoperatively is by endoscopic retrograde cholangiopancreatography (ERCP). Generally, in well-equipped centres of the world, ERCP followed by laparoscopic cholecystectomy is recommended as a safe and cost effective procedure. However, various centres advocate laparoscopic cholecystectomy with common bile duct (CBD) exploration or a Rendezvous technique where endoscopy and laparoscopy are performed simultaneously. The present article discusses the uses, advantages and disadvantages of ERCP against CBD exploration with primary closure or T-tube drainage.