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World J Gastrointest Endosc. Dec 16, 2011; 3(12): 248-255
Published online Dec 16, 2011. doi: 10.4253/wjge.v3.i12.248
Intraoperative ERCP: What role does it have in the era of laparoscopic cholecystectomy?
Luis R Rábago, Alejandro Ortega, Inmaculada Chico, David Collado, Ana Olivares, Jose Luis Castro, Elvira Quintanilla
Luis R Rábago, Alejandro Ortega, Inmaculada Chico, David Collado, Ana Olivares, Jose Luis Castro, Elvira Quintanilla, Department of Gastroenterology, Severo Ochoa Hospital, Leganes, 28911 Madrid, Spain
Author contributions: Rábago LR, Ortega A, Castro JL and Chico I contributed equally to the conception, design, and acquisition of data, analysis and interpretation of data; Collado D, Olivares A, Castro JL and Quintanilla E contributed to the drafting and critical review of the article for important intellectual content.
Correspondence to: Dr. Luis R Rabago, PhD, Department of Gastroenterology, Severo Ochoa Hospital, C/Orellana s/n, Leganes, 28911 Madrid, Spain. lrabagot@gmail.com
Telephone: +34-91-4818000 Fax: +34-91-6471917
Received: April 9, 2011
Revised: August 24, 2011
Accepted: December 1, 2011
Published online: December 16, 2011

In the treatment of patients with symptomatic cholelithiasis and choledocholithiasis (CBDS) detected during intraoperative cholangiography (IOC), or when the preoperative study of a patient at intermediate risk for CBDS cannot be completed due to the lack of imaging techniques required for confirmation, or if they are available and yield contradictory radiological and clinical results, patients can be treated using intraoperative endoscopic retrograde cholangiopancreatography (ERCP) during the laparoscopic treatment or postoperative ERCP if the IOC finds CBDS. The choice of treatment depends on the level of experience and availability of each option at each hospital. Intraoperative ERCP has the advantage of being a single-stage treatment and has a significant success rate, an easy learning curve, low morbidity involving a shorter hospital stay and lower costs than the two-stage treatments (postoperative and preoperative ERCP). Intraoperative ERCP is also a good salvage treatment when preoperative ERCP fails or when total laparoscopic management also fails.

Keywords: Intraoperative endoscopic retrograde cholangiopancreatography, Laparoendoscopic treatment, Postoperative endoscopic retrograde cholangiopancreatography, Rendezvous technique