Copyright ©The Author(s) 2021.
World J Gastroenterol. Jul 28, 2021; 27(28): 4536-4554
Published online Jul 28, 2021. doi: 10.3748/wjg.v27.i28.4536
Table 1 Factors that suggest the preference of the rendezvous technique over other treatments
Main indications for the laparo-endoscopic RV
RV preferable vs laparoscopic CBD exploration
RV preferable vs sequential ERCP-ES
(1) CBD stones not easily extractable(A) Need of higher surgical skill(a) Risk of synchronization
through the cystic duct(B) Longer operation time(b) Risk of unnecessary ERCP
Positive factor - > (time reduction)(C) Need of biliary drain(c) Risk of difficult retrograde
(2) Multiple small CBD stones and large friable stonesA, B, C +a, b, c
Positive factor - > (reduction of risk of recurrence)(D) High risk of residual fragments and recurrence
(3) Any type of CBD stones with delayed passage of theA, B, C, D +a, b, c
contrast medium during IOC or T-tube-IOC after(E) High risk of undertreatment of chronic
laparoscopic CBD explorationpapillitis and of maintenance of underlying causes
Positive factor - > (reduction of risk of recurrence)
(4) CBD stones with previous cholangitisA, B, C, D +a, b, c +
Positive factor - > (reduction of risk of recurrence)(E) High risk of maintenance of underlying causes(d) Avoidance of contrast medium injection
at the papillawith risk of recurrence of cholangitis
(5) CBD stones after recurrent acute biliary pancreatitisA, B, C, D, Ea, b, c, d +
or hyperbilirubinemia(e) risk of recurrence of ERCP
Positive factor - > (iatrogenic risk reduction)related acute pancreatitis
(6) Known or unsuspected sphincter of Oddi dysfunction,A, B, C, D, Ea, b, c, d, e
cholecysto-lithiasis with or without CBD stones
Positive factor - > (iatrogenic risk reduction)
(7) CBD stones and/or abovementioned problems in patientsA, B, C, D, E +a, b, c, d, e +
with Billroth Ⅱ during open cholecystectomy(F) Manual drive of the endoscope by the surgeon(f) more difficult ERCP
Positive factor - > (iatrogenic risk reduction)in the afferent jejunal loop
(8) CBD stones, SOD, acute pancreatitis in children/CBDA, B, C, D, E +a, b, c, d, e, f +
stones in patients with normal or thin CBD(G) difficult laparoscopic CBD exploration and risk(h) avoidance of
Positive factor -> (iatrogenic risk reduction)of stenosis of the suturesphincterotomy in children
(9) CBD stones and/or SOD after failure of preoperativeA, B, C, D, Ea, b, c, d, e, f
ERCP-ES or recurrence of acute biliary pancreatitis
Positive factor - > (iatrogenic risk reduction)
(10) Inexperienced surgeon for laparoscopic CBD explorationA, B, C, D, E, Ga, b, c, d, e, f
Positive factor - > (iatrogenic risk reduction)