As laparoscopic cholecystectomy becomes more prevalent, the unexpected finding of common duct stones by operative cholangiography presents a therapeutic dilemma for the surgeon. We present our current techniques for laparoscopic cholangiography and management of choledocholithiasis, including the use of angioplasty balloons for ampullary dilation.

In the context of advanced military computing projects consisting of applied research and development activities, software prototyping provides an effective development alternative to more traditional sofrware engineering models. However, as currently practiced, most prototype development models sufler from a number of shortcomings [ I , 31, most notably the lack of management and control over the process. Therefore, a new software development methodology is proposed that integrates evolutionary prototyping techniques and traditional planning and review activities. The proposed methodology, Tri-Cycle, prescribes a framework that promotes a disciplined approach to better plan, monitor, and evaluate software development without h e d i n g development progress. Currently, early versions of this methodology are being integrated into most of our existing projects. These versions have been well received by both current and prospective CUStomers.