Choledocholithiasis and endo-laparoscopic rendezvous. Analysis of 59 consecutive cases

Abstract

BACKGROUND: Choledocholithiasis is a real problem of major clinical importance. The incidence of cholelithiasis is 10-20%.

MATERIALS: We have examined 2907 patients treated with videolaparoscopic cholecystectomy (VLC) between January 2001 and September 2009. 214 cases (7.4%) were affected by choledocolithiasis; among these, 59 consecutive cases were treated by rendezvous, 151 cases by sequential treatment (ERCP-ES before VLC), 3 cases by extraction with Dormia’s basket, and 1 case by ERCP-ES after VLC.

RESULTS: The complications were one biliary fistula and three hemorrhages (one from the cystic artery, one from the hepatic area and one from trocar’s site). The mean hospital stay was 1.38±0.83 days for the rendezvous group vs 4.

53±0.74 days in the sequential treatment group (p<0.004). The satisfaction scores were 6.6±1.39 versus 5.7±0.96 (p<0.004).

CONCLUSIONS: The rendezvous procedure reduces hospital stay and has a greater compliance (only one treatment). We can use this option in the management of cases where preoperative ERCP-ES has failed.