Cirugia espanola · 2026
Outcomes of laparoendoscopic rendezvous for cholecysto-choledocolithiasis: A single series of 389 cases from a teaching hospital in Santiago, Chile.
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Hudson Ana, Farfan Felipe, Salazar Marco, Catan Felipe, Muñoz Jorge, Uribe Mario, Riquelme Francisco
Аннотация
BACKGROUND: The ideal management for cholecysto-choledocholithiasis remains controversial. A one-stage approach technique offers advantages over the two-stage approach, mainly by reducing postoperative complications, length of stay, and costs. This study aimed to describe the clinical and perioperative outcomes of laparoendoscopic rendezvous (LERV) for treating cholecysto-choledocholithiasis in elective and emergency settings.
METHODS: All patients with cholecysto-choledocholithiasis who underwent simultaneous cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) at a teaching hospital in Santiago, Chile, between January 2012 and December 2022 were included in this retrospective study.
RESULTS: Of 389 patients included, LERV was achieved by placing a guidewire through the cystic duct into the duodenum in 79% (309/389) of the patients. When the anterograde guidewire placement failed, intraoperative ERCP was performed. Common bile duct cannulation rate was 99.5% (387/389) and clearance rate was 90% (350/389). The overall morbidity rate was 11.6% (45/389) and surgical complication rate was 6.9%. Surgical morbidity was lower in the LERV group than in the group in which anterograde guidewire placement was not achieved (p = 0.02).
CONCLUSIONS: The LERV procedure is a safe, feasible, and efficient tool for treating cholecysto-choledocholithiasis. When guided ERCP cannulation was not achieved, inferior intraoperative and postoperative outcomes were observed.
METHODS: All patients with cholecysto-choledocholithiasis who underwent simultaneous cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) at a teaching hospital in Santiago, Chile, between January 2012 and December 2022 were included in this retrospective study.
RESULTS: Of 389 patients included, LERV was achieved by placing a guidewire through the cystic duct into the duodenum in 79% (309/389) of the patients. When the anterograde guidewire placement failed, intraoperative ERCP was performed. Common bile duct cannulation rate was 99.5% (387/389) and clearance rate was 90% (350/389). The overall morbidity rate was 11.6% (45/389) and surgical complication rate was 6.9%. Surgical morbidity was lower in the LERV group than in the group in which anterograde guidewire placement was not achieved (p = 0.02).
CONCLUSIONS: The LERV procedure is a safe, feasible, and efficient tool for treating cholecysto-choledocholithiasis. When guided ERCP cannulation was not achieved, inferior intraoperative and postoperative outcomes were observed.