Rendezvous "Laparo-Endoscopic" Management of Cholecysto-Choledocholithiasis: A Comparison Between Two Techniques

Abstract

Background: To maintain the less invasive approach to cholecysto-choledocholithiasis treatment, other alternatives have been suggested, including single-step and two-step procedures. Aims and objectives: To assess the safety, accuracy, and effectiveness of Rendezvous techniques as a single-step treatment for cholecysto-choledocholithiasis and compare two different techniques (Dormia basket and Guide wire) regarding operative timing, safety, feasibility, failure, and complications. Material and Methods: This research was done on 40 cases (20 cases in group A "Dormia Basket" and 20 cases in group B "Guidewire") at the Theodor Bilharz Research Institute (TBRI), General Surgery Department, during the period from November 2021 to October 2023.Results: There was no statistically significant variance among both groups concerning the existence of common bile duct stones (CBDS) in scans "Ultrasound (US), Magnetic Resonance Cholangiopancreatography (MRCP)," CBD diameter, the rendezvous "Laparoendoscopic" technique stage I, intraoperative and postoperative sequale, postoperative hospital stay, and follow-up till normalization of the liver functions or the presence of recurrent CBD stones by US, while there was statistically significant variance among both groups concerning the rendezvous "Laparo-endoscopic" technique stage II and stage III. Conclusion: A one-stage laparo-endoscopic approach to cholecysto-choledocholithiasis is a safe and effective way to remove CBD stones with a small amount of time spent in the operating room, minimal risk of postoperative pancreatitis, and a quick recovery period. Our research indicates that the laparo-endoscopicrendezvous' approach utilizing a Dormia basket catheter is superior to a flexible guidewire for duodenal papilla cannulation with a statistically significant difference in operating time.