Choledocholithiasis and endo-laparoscopic rendezvous. Analysis of 59 consecutive cases

Ann Ital Chir. 2011 May-Jun;82(3):221-4.

Abstract

Background: Choledocholithiasis is a real problem of major clinical importance. The incidence of cholelithiasis is 10-20%.

Materials: We have examined 2907 patients treated with videolaparoscopic cholecystectomy (VLC) between January 2001 and September 2009. 214 cases (7.4%) were affected by choledocolithiasis; among these, 59 consecutive cases were treated by rendezvous, 151 cases by sequential treatment (ERCP-ES before VLC), 3 cases by extraction with Dormia's basket, and 1 case by ERCP-ES after VLC.

Results: The complications were one biliary fistula and three hemorrhages (one from the cystic artery, one from the hepatic area and one from trocar's site). The mean hospital stay was 1.38 +/- 0.83 days for the rendezvous group vs 4 53 +/- 0.74 days in the sequential treatment group (p<0.004). The satisfaction scores were 6.6 +/- 1.39 versus 5.7 +/- 0.96 (p<0.004).

Conclusions: The rendezvous procedure reduces hospital stay and has a greater compliance (only one treatment). We can use this option in the management of cases where preoperative ERCP-ES has failed.

MeSH terms

  • Cholecystectomy, Laparoscopic* / methods
  • Choledocholithiasis / surgery*
  • Humans
  • Prospective Studies
  • Video-Assisted Surgery