Preoperative Endoscopic Sphincterotomy Versus Laparoendoscopic Rendezvous in Patients With Gallbladder and Bile Duct Stones

Morino, Mario; F, Baracchi; Miglietta, C; Furlan, N. M.; Ragona, Riccardo; Garbarini, A

doi:10.1097/01.sla.0000246913.74870.fc

Cited by 160 publications

(178 citation statements)

References 20 publications

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“…The reduction and facilitation of the steps of the endoscopic procedure due to the surgeon's help of the endoscopist finally brings a relevant reduction of the time of the endoscopic procedure. Moreover the post-procedural hyperamylasemia and acute pancreatitis are strongly reduced or absent after RV if compared to standard ERCP [6,8,16] and this is principally related to avoidance of the risk factors reported in Table 1. These factors are those clearly related to the incidence and mechanism of post-ERCP pancreatitis in different analyses [31][32][33][34] .…”

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%

“…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%

See 2 more Smart Citations

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%

Section: Discussionmentioning

confidence: 99%

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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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show abstract

“…On the other hand, a recently published low-quality RCT compare success rate, length of hospital stay, clinical results, and costs of sequential treatment (ERCP followed by LC) vs. the laparoendoscopic rendezvous in patients with CBDL and verified that laparoendoscopic rendezvous technique allows a higher rate of CBDL clearance, shorter hospital stay and cost reduction respect the ERCP followed by LC group (Morino, 2006)…”

Section: (Treatment Studies 1a)mentioning

confidence: 99%

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

et al. 2010

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SUMMARY:The aim of the present study was to evaluate the available evidence on the effectiveness of laparoscopic surgery for treating gallstones and common bile duct lithiasis (CBDL). A systematic overview was performed. Medline, EMBASE and The Cochrane Library were searched (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008). Systematic reviews (SR), clinical practice guidelines (CPG), randomised clinical trials (RCT) and observational studies were included. Internal validity and overall quality of the evidence were assessed. The available evidence was classified according to the Oxford Centre for Evidence Based Medicine proposal. 87 studies were included in this review (12 SR, 23 RCT, 3 CPG, 13 cohort studies, 3 cross-sectional studies, 2 case and control studies and 31 case series). Compared with open cholecystectomy, laparoscopic cholecystectomy (LC) is associated with shorter operating time, shorter hospital stay and better quality of life (high quality evidence). The use of antibiotic prophylaxis does not appear to reduce the infection rate in low-risk patients (high quality evidence). Although many techniques have been advocated to perform LC their effectiveness is as yet inconclusive (low-quality evidence). Two-stage surgery is the most appropriate strategy for high-risk patients with CBDL (high-quality evidence). Mortality is similar to open surgery, as the effectiveness is similar to that of endoscopic treatment (high-quality evidence). As a conclusion we can state that the evidence concerning the effectiveness of laparoscopic surgery for gallstones and CBDL is scarce and of low methodological quality and that better quality studies are warranted to assess these techniques more adequately.

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“…31 Intraoperative ERCP at the time of laparoscopic cholecystectomy, although less costly, may be logistically challenging and prolongs operative times.…”

Section: Pre-or Postoperative Ercp Versus Laparoscopic Cholecystectomymentioning

confidence: 99%

Management of suspected stones in the common bile duct

Almadi

Barkun

2012

CMAJ

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Preoperative Endoscopic Sphincterotomy Versus Laparoendoscopic Rendezvous in Patients With Gallbladder and Bile Duct Stones

Abstract: When compared with preoperative ERCP with ES followed by LC, the laparoendoscopic rendezvous technique allows a higher rate of CBD stones clearance, a shorter hospital stay, and a reduction in costs.

Cited by 160 publications

References 20 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

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

Management of suspected stones in the common bile duct

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