Surgical Endoscopy

, Volume 24, Issue 10, pp 2603–2606

Laparoendoscopic rendezvous: an effective alternative to a failed preoperative ERCP in patients with cholecystocholedocholithiasis

  • George Tzovaras
  • Ioannis Baloyiannis
  • Andreas Kapsoritakis
  • Athanassios Psychos
  • George Paroutoglou
  • Spyros Potamianos
Article

DOI: 10.1007/s00464-010-1015-0

Cite this article as:
Tzovaras, G., Baloyiannis, I., Kapsoritakis, A. et al. Surg Endosc (2010) 24: 2603. doi:10.1007/s00464-010-1015-0

Abstract

Background

Although the ideal management of cholelithiasis and concomitant choledocholithiasis is controversial, the two-stage approach [endoscopic retrograde cholangiopancreatography (ERCP), sphincterotomy, and common bile duct (CBD) clearance followed by laparoscopic cholecystectomy] is the most popular treatment regimen worldwide. However, sometimes ERCP fails to solve the problem of choledocholithiasis preoperatively. The aim of this study was to evaluate the use of intraoperative ERCP using the laparoendoscopic “rendezvous” technique in patients in whom preoperative ERCP has failed or was not possible to attempt.

Methods

Twenty-two patients (13 female, nine male), in whom ERCP failed or was not possible to be performed as a separate procedure before laparoscopic cholecystectomy, were treated with the one-stage approach of intraoperative ERCP during laparoscopic cholecystectomy using the so-called laparoendoscopic “rendezvous” technique.

Results

The one-stage approach was completed successfully in a median time of 110 min (range = 75–160 min) in 21 cases; however, in two cases the wire introduced via the cystic duct could not be advanced through Vater’s ampulla into the duodenum and the CBD was cannulated from the endoscopic route, in the usual way. There was no mortality or morbidity and most patients were discharged within 48 h after the procedure.

Conclusion

The laparoendoscopic “rendezvous” is a valuable alternative in treating patients with cholecystocholedocholithiasis. It appears to be a reliable method when preoperative ERCP fails to clear the CBD, while it also offers a one-stage solution to the problem.

Keywords

Bilio Common bile duct (CBD) Endoscopic retrograde cholangiopancreatography (ERCP) Cholecystectomy 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • George Tzovaras
    • 1
    • 2
  • Ioannis Baloyiannis
    • 1
  • Andreas Kapsoritakis
    • 3
  • Athanassios Psychos
    • 3
  • George Paroutoglou
    • 3
  • Spyros Potamianos
    • 3
  1. 1.Department of SurgeryUniversity of Thessaly Medical School, University Hospital of LarissaLarissaGreece
  2. 2.LarissaGreece
  3. 3.Department of GastroenterologyUniversity of Thessaly Medical School, University Hospital of LarissaLarissaGreece

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