Combined laparoendoscopic approach for biliary lithiasis treatment.

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biliary Tract Surgery

Background:

• The optimal management of common bile duct stones during videolaparoscopic cholecystectomy remains debated.
• Current practice often involves a two-stage approach: endoscopic retrograde cholangiopancreatography (ERCP) before or after laparoscopic cholecystectomy.
• A single-stage, intraoperative ERCP with intervention is a newer proposed strategy.

Purpose of the Study:

• To compare the outcomes of a combined intraoperative ERCP approach versus a sequential ERCP and laparoscopic cholecystectomy for suspected common bile duct stones.
• To evaluate complications, postoperative monitoring, and hospital stay duration for both treatment strategies.

Main Methods:

• A retrospective comparison of 21 patients undergoing combined intraoperative ERCP during laparoscopic cholecystectomy versus 17 patients with sequential ERCP prior to laparoscopic cholecystectomy.
• Analysis focused on complication rates, monitoring requirements, and length of hospital stay.

Main Results:

• Both the combined and sequential approaches demonstrated similar efficacy and complication rates.
• Patients treated with the sequential approach experienced longer hospital stays due to dual monitoring periods post-ERCP and post-cholecystectomy.

Conclusions:

• The combined intraoperative ERCP approach for common bile duct stones during videolaparoscopic cholecystectomy is effective.
• This integrated strategy presents a potentially more cost-effective treatment option by reducing overall hospital stay.