Skip to main content

ERCP and laparoscopic cholecystectomy in a combined (one-step) procedure with a novel technique


This study compared the benefit of the novel one- step procedure for the managment of calculous biliary disease.


A retrospective review of 25 geriatric patients was conducted one-step procedure with positionament of loop in digiuno for reductions a little bowel distenction. In 24 of the patients, the one-step technique was successful (96 %); in the remaining 1 patient (4%), conversion open technique was necessary; in this case not positionament of loop in jejunum. We define the one-step procedure to be a laparoscopic cholecystectomy whit IOC to confirm the presence of stone, to be a gold standard; intraoperative ERCP whit stone extraction was conected if necessary as part of the one-step procedure.


This technique evidence a statistically significant difference of the hospital cost, such us the length of the stay and pre operative day and reduce the high conversion rate with alternatively technique in two-step. The incidence of overall complications was lower in the one-step technique. The findings showed that one-step technique was associated with less clinical pancreatitis respect at the two-stage technique.


A laparoscopic cholecystectomy after ES is lengthier and more difficult then in uncomplicated cholelithiasis and should therefore be performed by an experienced surgeon. This new technique appears to be a significant conversion reduction versus two step procedure, and reduce the cost of hospitality and length of stay and preoperative days. Further research with a larger study population is necessary to determine the additional benefits of this procedure.


  1. Noel R, Enochsson L, Swahn F, Löhr M, Nilsson M, Permert J, Arnelo U: A 10-year study of rendezvous intraoperative endoscopic retrograde cholangiography during cholecystectomy and the risk of post-ERCP pancreatitis. Surg Endosc. 2013

    Google Scholar 

  2. Reinders JS, Gouma DJ, Heisterkamp J, Tromp E, van Ramshorst B, Boerma D: Laparoscopic cholecystectomy is more difficult after a previous endoscopic retrograde cholangiography. HPB (Oxford). 2013, 15 (3): 230-4. 10.1111/j.1477-2574.2012.00582.x.

    Article  Google Scholar 

  3. Wang B, Guo Z, Liu Z, Wang Y, Si Y, Zhu Y, Jin M: Preoperative versus intraoperative endoscopic sphincterotomy in patients with gallbladder and suspected common bile duct stones: system review and meta-analysis. Surg Endosc. 2013

    Google Scholar 

  4. Jones M, Johnson M, Samourjian E, Slauch K, Ozobia N: ERCP and laparoscopic cholecystectomy in a combined (one-step) procedure: a random comparison to the standard (two-step) procedure. Surg Endosc. 2012

    Google Scholar 

  5. Pereira-Graterol F, Venales-Barrios Y, Bousquet-Suárez J, Cáceres-Cauro A, Romero-Bravo C, Moreno-Rodríguez J, Rodríguez-Perero L: [The "rendez-vous" maneuver as a technical option to access the bile ducts: Case series report]. Rev Gastroenterol Mex. 2012, 77 (4): 224-8. 10.1016/j.rgmx.2012.04.011.

    CAS  PubMed  Google Scholar 

  6. Arezzo A, Vettoretto N, Famiglietti F, Moja L, Morino M: Laparoendoscopic rendezvous reduces perioperative morbidity and risk of pancreatitis. Surg Endosc. 2013, 27 (4): 1055-60. 10.1007/s00464-012-2562-3. doi: 10.1007/s00464-012-2562-3

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Luigi De Santis.

Rights and permissions

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and Permissions

About this article

Cite this article

De Santis, L. ERCP and laparoscopic cholecystectomy in a combined (one-step) procedure with a novel technique. BMC Surg 13 (Suppl 1), A15 (2013).

Download citation

  • Published:

  • DOI:


  • Pancreatitis
  • Laparoscopic Cholecystectomy
  • Cholelithiasis
  • Geriatric Patient
  • Step Procedure