Laparoendoscopic rendezvous for paediatric cholecysto-choledocholithiasis: A safe and effective single-stage approach with technical insights.

INTRODUCTION

Paediatric choledocholithiasis is increasingly encountered in clinical practice. The conventional two-stage strategy of endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy is effective but technically demanding and associated with procedure-related complications. Laparoendoscopic rendezvous (LERV) offers a single-stage minimally invasive alternative; however, paediatric evidence remains limited.

PATIENTS AND

METHODS

This retrospective single-centre study included seven consecutive paediatric patients (4 males, 3 females; median age: 14 years; range: 9-17 years) with cholecysto-choledocholithiasis who underwent LERV between March 2021 and September 2025. The primary endpoint was complete common bile duct (CBD) stone clearance. Secondary endpoints included operative time, complications and length of hospital stay.

RESULTS

LERV was successfully completed in all patients, achieving complete CBD stone clearance without conversion to open surgery or the need for additional interventions. Median operative time was 110 min (range: 80-140), and median hospital stay was 2 days (range: 2-4). No intraoperative or post-operative complications occurred. Mean follow-up was 38.6 months, with no late biliary complications or recurrent stones.

CONCLUSION

LERV appears to be a feasible and promising single-stage technique for selected paediatric patients with cholecysto-choledocholithiasis, providing high ductal clearance while avoiding additional procedures. The standardised step-by-step technique presented may facilitate reproducibility and broader adoption in paediatric surgical practice.