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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 14, 2008; 14(18): 2844-2850
Published online May 14, 2008. doi: 10.3748/wjg.14.2844
Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work
Gaetano La Greca, Francesco Barbagallo, Michele Di Blasi, Andrea Chisari, Rosario Lombardo, Rosario Bonaccorso, Saverio Latteri, Andrea Di Stefano, Domenico Russello
Gaetano La Greca, Francesco Barbagallo, Andrea Chisari, Rosario Lombardo, Rosario Bonaccorso, Saverio Latteri, Andrea Di Stefano, Domenico Russello, Department of Surgical Sciences, Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, Via Messina 829, Catania 95126, Italy
Michele Di Blasi, Endoscopic Unit, Cannizzaro Hospital, Via Messina 829, Catania 95126, Italy
Author contributions: La Greca G designed the study, performed the research and wrote the paper; Barbagallo F, chief investigator and guided the research work; Di Blasi M, performed endoscopic procedures; Lombardo R, Bonaccorso R, Di Stefano A, Russello D provided the patient material and other clinical data; Chisari A, Latteri S, tables and drafting.
Correspondence to: Gaetano La Greca, MD, PhD, Via Messina 354; Catania 95126, Italy. glagreca@unict.it
Telephone: +39-095-7263586
Fax: +39-095-7122221
Received: January 28, 2008
Revised: March 29, 2008
Published online: May 14, 2008

AIM: To investigate our clinical experience with combined laparo-endoscopic Rendezvous (RV) for the treatment of patients affected by gallstones and common bile duct (CBD) stones and especially to study the never evaluated opinion of the endoscopist concerning the difficulty of the intraoperative endoscopic procedure during the RV in comparison with standard endoscopic retrograde cholangio-pancreatography (ERCP).

METHODS: Eighty consecutive patients affected by cholecystolithiasis and diagnosed or suspected CBD stones were treated with a standardized “tailored” RV. The relevant technical features, the feasibility, the effectiveness in stone clearance, the safety but also the simple evaluation of difficulty and agreement of the endoscopist were analyzed with a questionnaire.

RESULTS: The feasibility was 97.5% and the effectiveness 100% concerning CBD clearance and solution of coexisting problems at the papilla. Minor morbidity was 3.3%, the operating time was prolonged by a mean of 14 min, the mean hospital stay was 3.8 d and only one stone’s recurrence occurred. The endoscopist evaluated the procedure to be simpler than standard ERCP-ES in 81.2% of the cases.

CONCLUSION: Simultaneous RV carries high effectiveness and safety at least comparable to those reported for other options. The endoscopist is very often satisfied with this approach because of the minimization of some steps of the endoscopic procedure and avoidance of relevant iatrogenic risk factors. If the mandatory collaboration between surgeons and endoscopists is guaranteed, this approach can often be preferable for the patient, the surgeon, the endoscopist and the hospital.

Keywords: Gallstones, Common bile duct, Endoscopic retrograde cholangio-pancreatography, Endoscopic sphincterotomy, Rendezvous, Intra-operative cholangiography, Laparoscopic cholecystectomy