Single-Stage Laparoscopic-Endoscopic Rendezvous Technique for Choledocholithiasis: Clinical Outcomes From 1008...

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Minimally Invasive Procedures
• Biliary Tract Interventions

Background:

• Two-stage management of choledocholithiasis presents risks like complications, repeat procedures, and prolonged hospital stays.
• Single-stage laparoscopic common bile duct exploration requires advanced skills, posing a barrier to adoption.

Purpose of the Study:

• To evaluate the outcomes of the single-stage laparoscopic-endoscopic rendezvous (LER) technique for common bile duct stone management.
• To assess the safety, efficacy, and reproducibility of LER in a large patient cohort.

Main Methods:

• Retrospective analysis of 1,008 adult patients with symptomatic cholelithiasis and common bile duct stones (≤15 mm) from 2016-2024.
• Primary outcome: procedural success (complete clearance without conversion).
• Secondary outcomes: 30-day morbidity and post-ERCP pancreatitis (PEP) incidence.

Main Results:

• Procedural success rate of 92.0% (927/1008 patients) with a mean operative time of 52.4 minutes.
• Low 30-day minor complication rate of 1.9% and zero cases of post-ERCP pancreatitis (PEP).
• More than three stones was the only independent predictor of procedural failure (OR 4.21).

Conclusions:

• Single-stage LER is a safe, efficient, and reproducible technique for managing common bile duct stones.
• The LER technique effectively eliminates post-ERCP pancreatitis and achieves high rates of ductal clearance.
• LER offers a valuable alternative to traditional two-stage approaches, particularly for patients requiring advanced laparoscopic expertise.