Endolaparoscopic treatment of cholecysto-choledochal lithiasis. Personal experience

Abstract

AIM OF THE STUDY: To demonstrate how, on the basis of the personal experience, the rendez-vous technique, in the management of cholelithiasis associated with choledocolithiasis , whenever there is the indication, is better than the sequential treatment.

METHODS: From January 2008 to May 2011, 48 patients with cholelithiasis and choledocolithiasis combined were treated with endolaparoscopic technique. Of these patients, 23 were treated with the sequential treatment and 25 with the rendez-vous method. We attempted to define the indications for endolaparoscopic rendez-vous: – cholelithiasis associated with choledocolithiasis or biliary sludge not bigger than 1 cm; – permeability of the colecystic duct; – a clinical picture of medium-low importance.

CONCLUSIONS: The data of the study confirm the superiority of the rendez-vous technique because it resolves cholelithiasis associated with choledocolithiasis in a single surgical act with greater acceptance of the patient who avoids a second invasive surgical act; moreover it requires shorter hospitalization and convalescence, resulting in reduced costs. Finally the data analyzed show a reduction in complications compared to sequential treatment