Objectives: The simultaneous laparo-endoscopic “rendez-vous” (LERV) represents an alternative to sequential or totally laparoscopic approaches for patients affected by cholecystocholedocholithiasis. The aim of this study was to analyze the results in a large series of 210 consecutive patients. Methods: From 2002 to 2016 all patients affected by cholecystocholedocholithiasis were treated with a standardized “tailored” LERV. The relevant technical features of the procedure were recorded. An analysis of feasibility, effectiveness in stone clearance and safety was performed. Results: Among 214 patients with CBD stones, 210 were treated with LERV and 4 with open rendez-vous approach. Intra-operative cholangiography (IOC) confirmed common bile duct (CBD) stones in 179 patients (85.2%) or sludge in 18 (8.5%) and in 98.9% stone clearance was obtained endoscopically. Endoscopic papilla cannulation was feasible in 161 patients (76.7%) whereas in 49 (23.3%) a trans-cystic guide wire was needed. The overall LERV feasibility was 96.6%. The conversion rate to open surgery was 3.3%. Minor morbidity was observed in 1.9% of cases, mortality in 0.47% and the mean hospital stay was 4.3 days. Conclusions: These results confirm the high effectiveness of LERV. This approach to treat cholecystocholedocholithiasis should be preferred and therefore implemented where a strong collaboration between surgeons and endoscopists is possible.
EFFICACY OF THE LAPAROENDOSCOPIC “RENDEZ-VOUS” TO TREAT BILE DUCT STONES IN 210 CONSECUTIVE PATIENTS. A SINGLE CENTER EXPERIENCE / Pesce, A., La Greca, G., Di Marco, F., Di Blasi, M., Puleo, S., Russello, D., Latteri, S.. - (2017). (IASGO WORLD CONGRESS LYON ).
EFFICACY OF THE LAPAROENDOSCOPIC “RENDEZ-VOUS” TO TREAT BILE DUCT STONES IN 210 CONSECUTIVE PATIENTS. A SINGLE CENTER EXPERIENCE.
Pesce A;
2017
Abstract
Objectives: The simultaneous laparo-endoscopic “rendez-vous” (LERV) represents an alternative to sequential or totally laparoscopic approaches for patients affected by cholecystocholedocholithiasis. The aim of this study was to analyze the results in a large series of 210 consecutive patients. Methods: From 2002 to 2016 all patients affected by cholecystocholedocholithiasis were treated with a standardized “tailored” LERV. The relevant technical features of the procedure were recorded. An analysis of feasibility, effectiveness in stone clearance and safety was performed. Results: Among 214 patients with CBD stones, 210 were treated with LERV and 4 with open rendez-vous approach. Intra-operative cholangiography (IOC) confirmed common bile duct (CBD) stones in 179 patients (85.2%) or sludge in 18 (8.5%) and in 98.9% stone clearance was obtained endoscopically. Endoscopic papilla cannulation was feasible in 161 patients (76.7%) whereas in 49 (23.3%) a trans-cystic guide wire was needed. The overall LERV feasibility was 96.6%. The conversion rate to open surgery was 3.3%. Minor morbidity was observed in 1.9% of cases, mortality in 0.47% and the mean hospital stay was 4.3 days. Conclusions: These results confirm the high effectiveness of LERV. This approach to treat cholecystocholedocholithiasis should be preferred and therefore implemented where a strong collaboration between surgeons and endoscopists is possible.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
