Laparo-endoscopic rendez-vous versus sequential "delayed" approach in patients with choledocholithiasis

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biliary Tract Diseases

Background:

• Gallstones and common bile duct (CBD) stones present a significant clinical challenge.
• Current treatment strategies involve various endoscopic and surgical interventions.

Purpose of the Study:

• To compare the efficacy and safety of the synchronous laparo-endoscopic rendez-vous (LRV) technique versus a sequential "delayed" approach for managing gallstones and CBD stones.
• Key comparison points include conversion rates and postoperative complications.

Main Methods:

• A comparative study involving 43 patients in the sequential ERCP-then-laparoscopic cholecystectomy group and 46 patients in the LRV group.
• Standardized endoscopic procedures were performed by a single endoscopist.
• Data collected included patient demographics, operative details, and clinical outcomes.

Main Results:

• The conversion rate to open surgery was 11.6% in the sequential group versus 2.2% in the LRV group (P=0.10).
• Postoperative complications occurred in 7% of the sequential group and 2.2% of the LRV group (P=0.35).
• No mortality or bilio-pancreatic events were recorded in either group.

Conclusions:

• The laparo-endoscopic rendez-vous (LRV) technique does not demonstrate significant advantages over the delayed sequential approach for conversion rates and postoperative complications.
• Larger patient cohorts are recommended for further investigation into the LRV approach.