Laparoendoscopic Rendez-Vous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis

Rossana Percario; Paolo Panaccio; Maria Pia Caldarella; Marco Trappoliere; Maria Marino; Vincenzo Casolino; Maira Farrukh; Severino Cericola; Simone Di Russo; Carla Di Giacomo; Giovanni De Nobili; Tommaso Grottola; Pierluigi Di Sebastiano; Francesco Fabio Di Mola

doi:10.20944/preprints202405.1302.v1

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preprints.org > medicine and pharmacology > surgery > doi: 10.20944/preprints202405.1302.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Laparoendoscopic Rendez-Vous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis

^* ,

Pierluigi Di Sebastiano

Francesco Fabio Di Mola

Version 1 : Received: 20 May 2024 / Approved: 20 May 2024 / Online: 20 May 2024 (15:07:17 CEST)

How to cite: Percario, R.; Panaccio, P.; Caldarella, M. P.; Trappoliere, M.; Marino, M.; Casolino, V.; Farrukh, M.; Cericola, S.; Di Russo, S.; Di Giacomo, C.; De Nobili, G.; Grottola, T.; Di Sebastiano, P.; Di Mola, F. F. Laparoendoscopic Rendez-Vous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis. Preprints 2024, 2024051302. https://doi.org/10.20944/preprints202405.1302.v1 Percario, R.; Panaccio, P.; Caldarella, M. P.; Trappoliere, M.; Marino, M.; Casolino, V.; Farrukh, M.; Cericola, S.; Di Russo, S.; Di Giacomo, C.; De Nobili, G.; Grottola, T.; Di Sebastiano, P.; Di Mola, F. F. Laparoendoscopic Rendez-Vous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis. Preprints 2024, 2024051302. https://doi.org/10.20944/preprints202405.1302.v1

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MDPI and ACS Style

Percario, R.; Panaccio, P.; Caldarella, M. P.; Trappoliere, M.; Marino, M.; Casolino, V.; Farrukh, M.; Cericola, S.; Di Russo, S.; Di Giacomo, C.; De Nobili, G.; Grottola, T.; Di Sebastiano, P.; Di Mola, F. F. Laparoendoscopic Rendez-Vous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis. Preprints 2024, 2024051302. https://doi.org/10.20944/preprints202405.1302.v1

APA Style

Percario, R., Panaccio, P., Caldarella, M. P., Trappoliere, M., Marino, M., Casolino, V., Farrukh, M., Cericola, S., Di Russo, S., Di Giacomo, C., De Nobili, G., Grottola, T., Di Sebastiano, P., & Di Mola, F. F. (2024). Laparoendoscopic Rendez-Vous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis. Preprints. https://doi.org/10.20944/preprints202405.1302.v1

Chicago/Turabian Style

Percario, R., Pierluigi Di Sebastiano and Francesco Fabio Di Mola. 2024 "Laparoendoscopic Rendez-Vous: An Effective and Safe Approach in the Management of Cholecysto-Choledocholithiasis" Preprints. https://doi.org/10.20944/preprints202405.1302.v1

Abstract

Background: The two-stage technique combining the Endoscopic Retrograde CholangioPancreatography (ERCP) with common bile duct (CBD) clearance carried out before the laparoscopic cholecystectomy represents the most common approach for CBD stones. Over time, different techniques have been proposed to manage cholecysto- choledocholithiasis (CCL) advantageously in one stage. Among these, the laparoendoscopic rendez-vous (LERV) addresses the CCL issue with a laparoscopic cholecystectomy with insertion of a guide wire performed at initial stage of the procedure, followed by the clearance of the bile duct carried out by the endoscopists. The goal of this study was to evaluate the efficacy and safeness of LERV procedure recording results and complications, also making a comparison between our results and current literature. Methods: We reviewed our experience of all consecutive patients with cholecysto-choledocholithiasis managed with LERV between January 2018 and December 2023. LERV success rate, operative time, length of hospital stay, stone recurrence, incidence of endoscopic and surgical complications were analysed. Results: A total of 120 patients underwent LERV in our facilities. We reported a 97% LERV success rate, 1.6% conversion-to-open rate, a median intraoperative time of 122 (range 95-220) min. The median hospital stay was 4 (range 2-38) days. An overall morbidity of 15% was reported (18/120): 15 Clavien-Dindo type 1/2, 2 type 3a and one type 3b. In two cases a re-operation during the hospital stay was necessary. At a median follow-up of 14 months (3-59) five patients experienced stone recurrence requiring redo-ERCP in two cases. Conclusion: LERV offers the significant advantage of a single stage procedure and hospitalisation along with a lower risk of post-ERCP pancreatitis, failed CBD cannulation and complications. Our experience confirms safety and effectiveness of the technique for CCL management.

Keywords

: cholecystocholedocholithiasis; Endoscopic retrograde cholangiopancreatography; Laparoscopic–endoscopic rendezvous; common bile duct exploration; pancreatitis

Subject

Medicine and Pharmacology, Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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