- Meeting abstract
- Open Access
ERCP and laparoscopic cholecystectomy in a combined (one-step) procedure with a novel technique
© De Santis; licensee BioMed Central Ltd. 2013
- Published: 16 September 2013
- Laparoscopic Cholecystectomy
- Geriatric Patient
- Step Procedure
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.
- 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. 2013Google Scholar
- 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.View ArticleGoogle Scholar
- 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. 2013Google Scholar
- 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. 2012Google Scholar
- 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.PubMedGoogle Scholar
- 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/s00464-012-2562-3View ArticlePubMedGoogle Scholar
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