Intraoperative endoscopic retrograde cholangiopancreatography (ERCP) to remove common bile duct stones during routine laparoscopic cholecystectomy does not prolong hospitalization: a 2-year experience

Enochsson, Lars; Lindberg, Bo; Swahn, Fredrik; Arnelo, Urban

doi:10.1007/s00464-003-9021-0

Cited by 111 publications

(73 citation statements)

References 29 publications

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“…In all other papers concerning the laparo-endoscopic RV mostly published by surgeons [1][2][3][4][5][6][7][8] , there never was an analysis of the problems related to the main technical factors of the endoscopic procedure, nor were the compliance and explanations from the point of view of the endoscopist considered. This is in our opinion a relevant lacking in the analysis of this particular procedure, for which we tried to make aware to both the surgeon and endoscopist concerning its utility as mandatory for its immediate outcome and for its development.…”

Section: Discussionmentioning

confidence: 99%

“…According to our results, the endoscopist's opinion and literature results, ERCP-ES with help seems to be easier for the endoscopist so that radiologicendoscopic rendezvous was also used [13,14] . On the other hand, CBD clearance during LC with help of the endoscopist also seems easier for the surgeon as all the surgeons using the RV were always satisfied, never reporting results or aspects that lead them to abandon it [1][2][3][4][5][6][7][8]15,16] . These patients are all treated in an in-patient hospital setting so normally both surgeon and endoscopist are available and the other mandatory factors to gain the organization of a RV are functioning clocks and telephones to coordinate them.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work

G¹,

Barbagallo²,

Blasi³

et al. 2008

WJG

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AIM:To investigate our clinical experience with combined laparo-endoscopic Rendezvous (RV) for the treatment of patients affected by gallstones and common bile duct (CBD) stones and especially to study the never evaluated opinion of the endoscopist concerning the difficulty of the intraoperative endoscopic procedure during the RV in comparison with standard endoscopic retrograde cholangio-pancreatography (ERCP). METHODS:Eighty consecutive patients affected by cholecystolithiasis and diagnosed or suspected CBD stones were treated with a standardized "tailored" RV. The relevant technical features, the feasibility, the effectiveness in stone clearance, the safety but also the simple evaluation of difficulty and agreement of the endoscopist were analyzed with a questionnaire. R E S U LT S :T h e f e a s i b i l i t y w a s 9 7. 5 % a n d t h e effectiveness 100% concerning CBD clearance and solution of coexisting problems at the papilla. Minor morbidity was 3.3%, the operating time was prolonged by a mean of 14 min, the mean hospital stay was 3.8 d and only one stone's recurrence occurred. The endoscopist evaluated the procedure to be simpler than standard ERCP-ES in 81.2% of the cases. C O N C L U S I O N :S i m u l t a n e o u s R V c a r r i e s h i g h effectiveness and safety at least comparable to those reported for other options. The endoscopist is very often satisfied with this approach because of the minimization of some steps of the endoscopic procedure and avoidance of relevant iatrogenic risk factors. If the mandatory collaboration between surgeons and endoscopists is guaranteed, this approach can often be preferable for the patient, the surgeon, the endoscopist and the hospital.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work

G¹,

Barbagallo²,

Blasi³

et al. 2008

WJG

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“…Many experiences were reported in the literature [60][61][62][63] , confirming safety, excellent CBD clearance percentages, and short learning curves. The adjunct of the intraoperative procedure does not prolong hospitalization of routine LC [64] .…”

Section: Intraoperative Ercp (With Concomitant Laparoscopic Cholecystmentioning

confidence: 98%

Modern approach to cholecysto-choledocholithiasis

Bencini¹

2014

WJGE

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Gallstones and common bile duct calculi are found to be associated in 8%-20% of patients, leading to possible life-threatening complications, such as acute biliary pancreatitis, jaundice and cholangitis. The gold standard of care for gallbladder calculi and isolated common bile duct stones is represented by laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography, respectively, while a debate still exists regarding how to treat the two diseases at the same time. Many therapeutic options are also available when the two conditions are associated, including many different types of treatment, which local professionals often administer. The need to limit maximum discomfort and risks for the patients, combined with the economic pressure of reducing costs and utilizing resources, favors single-step procedures. However, a multitude of data fail to strongly demonstrate the superiority of any technique (including a two or multi-step approach), while rigorous clinical trials that include so many different types of treatment are still lacking, and it is most likely unrealistic to conduct them in the future. Therefore, the choice of the best management is often led by the local presence of professional expertise and resources, rather than by a real superiority of one strategy over another.

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“…This approach is wholly dependent on the availability of endoscopic expertise in the operating room. Available results, although limited, show high clearance rates in excess of 90 %, with minimal morbidity and no increase in the length of hospital stay over that of laparoscopic cholecystectomy alone [26,27].…”

Section: Stones Discovered Intraoperativelymentioning

confidence: 99%

Management of Common Bile Duct Stones in the Laparoscopic Era

et al. 2012

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There is no consensus regarding the ideal management of concurrent gallbladder and common bile duct (CBD) stones. Currently the treatment protocol involves most commonly a sequential approach consisting of endoscopic sphincterotomy followed by laparoscopic cholecystectomy or a single stage laparoscopic procedure, including cholecystectomy and exploration of the CBD. For this article literature search was performed using online search engines, Google, Pubmed, the online Springer link library and the Cochrane Database Systematic Review. Review articles, prospective and retrospective studies which detailed or compared the various treatment strategies for CBD stones were selected and analyzed. This review article aims to provide an insight into the optimal management of CBD stones in different clinical scenarios. Endoscopic sphincterotomy has inherent morbidity and complications like CBD stone recurrence whereas laparoscopic CBD exploration demands considerable expertise which is available only at specialized centres. The clinical presentation of the patient, number of stones, size of CBD, available resources and technical expertise at hand are an important consideration for the ideal management in different scenarios.

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Intraoperative endoscopic retrograde cholangiopancreatography (ERCP) to remove common bile duct stones during routine laparoscopic cholecystectomy does not prolong hospitalization: a 2-year experience

Cited by 111 publications

References 29 publications

Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work

Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work

Modern approach to cholecysto-choledocholithiasis

Management of Common Bile Duct Stones in the Laparoscopic Era

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