Use of the laparoscopic–endoscopic approach, the so-called “rendezvous” technique, in cholecystocholedocholithiasis

Lella, F.; Bagnolo, F.; Rebuffat, C.; Scalambra, Marco; Bonassi, U.; Colombo, Elena

doi:10.1007/s00464-005-0356-6

Cited by 98 publications

(117 citation statements)

References 29 publications

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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: 69%

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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Section: Intraoperative Ercp (With Concomitant Laparoscopic Cholecystmentioning

confidence: 69%

Modern approach to cholecysto-choledocholithiasis

Bencini¹

2014

WJGE

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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: 94%

“…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%

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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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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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“…Currently, the options for management of preoperatively suspected choledocholithiasis include (1) preoperative ERCP, endoscopic sphincterotomy (ES), and stone extraction followed by LC [1,2,3]; (2) transcystic cholangiography followed by transcystic or direct CBD exploration [4,5,6,7]; (3) postoperative ERCP with ES and stone extraction [8,9,10]; (4) LC combined with intraoperative ERCP, ES and stone extraction [11,12,13,14], and (5) conversion to open cholecystectomy and CBD exploration [15,16,17,18,19]. …”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Exploration versus Intraoperative Endoscopic Sphincterotomy for Common Bile Duct Stones: A Prospective Randomized Trial

Elgeidie¹,

Elshobary²,

Naeem³

2011

Dig Surg

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Background/Aims: Laparoscopic cholecystectomy (LC) combined with intraoperative endoscopic sphincterotomy (IOES) was compared to LC with laparoscopic common bile duct exploration (LCBDE) to define the best single-session minimally invasive treatment for cholecystocholedocholithiasis. Methods: Between June 2009 and December 2010, patients with gallstones and common bile duct (CBD) stones diagnosed by preoperative ultrasonography and magnetic resonance cholangiopancreatography were randomized to LC-LCBDE or LC-IOES. The primary end point was complete clearance of CBD of stones. The secondary end points were operation time, conversion rate, length of hospital stay, complications and mortality. Results: Two hundred and twenty-six patients were eligible. They were randomized to LC-LCBDE (n = 115) and LC-IOES (n = 111). There was no statistically significant difference in the success rate of CBD clearance between the two interventions (92% for LC-LCBDE vs. 97.2% for LC-IOES with a p value >0.05). There were no differences between the two groups in terms of surgical time and postoperative length of stay. Pancreatitis and bleeding sphincterotomy were significantly more prevalent in the LC-IOES group, while bile leakage and retained CBD stones were significantly more prevalent in the LC-LCBDE group. Conclusion: Both LC-IOES and LC-LCBDE were shown to be safe, effective, minimally invasive treatments for cholecystocholedocholithiasis, but the former option may be preferred when facilities and experience in endoscopic therapy exist.

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Use of the laparoscopic–endoscopic approach, the so-called “rendezvous” technique, in cholecystocholedocholithiasis

Abstract: In cholecysthocholedocholithiasis, the combined laparoscopic-endoscopic approach prevents post-ERCP pancreatitis in cases with patient-related risk factors for this complication.

Cited by 98 publications

References 29 publications

Modern approach to cholecysto-choledocholithiasis

Modern approach to cholecysto-choledocholithiasis

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

Laparoscopic Exploration versus Intraoperative Endoscopic Sphincterotomy for Common Bile Duct Stones: A Prospective Randomized Trial

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