Two Institutes Experience in Laparo-Endoscopic Rendezvous Technique for Gallbladder and Bile Duct Stones

The management of gallbladder stones (lithiasis) concomitant with bile duct stones is controversial. The management of CBD stones has evolved considerably since the advent of laparoscopic surgery. The more frequent approach is a two-stage procedure, with endoscopic sphincterotomy and stone removal from the bile duct followed by laparoscopic cholecystectomy. The laparoscopic-endoscopic rendezvous combines the two techniques in a single-stage operation. So the aim of this study was was to evaluate one-stage LC with intra-operative endoscopic sphincterotomy (IOES) vs two-stage pre-operative endoscopic sphincterotomy (POES) followed by LC for the treatment of cholecystocholedocholithiasis.

Inclusion Criteria:patients having stone in the gallbladder and concurrent CBD stone, as determined by MRCP or US.Patients with acute cholecystitis, acute cholangitis, obstructive jaundice, and those with highly suspicious criteria for CBD, stones such as dilated CBD on US examination more than7 mm in diameter without obvious CBD stones, high serum bilirubin level, and or high serum alkaline phosphatase level, were also included in this study.Exclusion Criteria:Patients with history of hepatobiliary surgery as choledocho-duodenal anastomosis.Patients with previous ERCP attempt.Patients with previous upper abdominal surgery as total or partial gastric resection.Patients with morbid obesity.Patients with uncorrectable coagulopathy.Patients aged below 18 years or above 80 years.Patients within the American Society of Anesthesiology (ASA) class 4 and 5 disease.Patients who refused to give consent or participate in the study.