PMID- 27981825 OWN - NLM STAT- MEDLINE DCOM- 20180102 LR - 20180102 IS - 1827-1626 (Electronic) IS - 0026-4733 (Linking) VI - 72 IP - 2 DP - 2017 Apr TI - Laparo-endoscopic rendez-vous versus sequential "delayed" approach in patients with choledocholithiasis. PG - 98-102 LID - 10.23736/S0026-4733.16.07248-5 [doi] AB - BACKGROUND: The aim of this study was to compare the efficacy and safety of synchronous laparoscopic cholecystectomy with laparo-endoscopic rendez-vous (LRV) technique vs. sequential "delayed" approach with the main goal to compare the conversion rate and postoperative complications. METHODS: Patients diagnosed as having gallstones and CBD stones or sludge were enrolled in this study. From January 2013 to June 2015, 43 consecutive patients were submitted to the sequential treatment (ERCP prior to laparoscopic cholecystectomy) and the next consecutive 46 patients were submitted to undergo the rendez-vous technique. All endoscopic procedures in both groups were performed by the same endoscopist with the same technique. Data were collected on patient age, gender, latency operation time, duration of surgery, bilio-pancreatic events, hospital stay, mortality, conversion rate and postoperative complications. RESULTS: The overall mean age was 58 years-old (25-84 years) with 43 males (48.3%) and 46 females (51.7%). The conversion rate to open surgery was 11.6% in the "sequential group" vs. 2.2% in the LRV group with a P value 0.10. The reasons for conversion included in the first group unclear anatomy (in 2 patients) and severe adhesions (in the remnant 3 patient), and in the second group unclear anatomy (in one patient). No bilio-pancreatic events occurred in the waiting period for LC in the first group. No mortality was recorded in either group. Postoperative complications were seen in 7% of patients in the "sequential group" vs. 2.2% in the rendez-vous group (P value 0.35). CONCLUSIONS: LRV does not present real advantages in comparison to delayed sequential approach in terms of conversion rate and postoperative complications. However, these results require further elaboration in studies on large numbers of patients undergoing LRV approach. FAU - Pesce, Antonio AU - Pesce A AD - Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy - nino.fish@hotmail.it. FAU - LA Greca, Gaetano AU - LA Greca G AD - Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy. FAU - Latteri, Saverio AU - Latteri S AD - Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy. FAU - Guardabasso, Vincenzo AU - Guardabasso V AD - Policlinic Hospital "G. Rodolico", Catania, Italy. FAU - DI Marco, Federica AU - DI Marco F AD - Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy. FAU - DI Blasi, Michele AU - DI Blasi M AD - Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy. FAU - Russello, Domenico AU - Russello D AD - Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy. FAU - Puleo, Stefano AU - Puleo S AD - Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy. LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article DEP - 20161216 PL - Italy TA - Minerva Chir JT - Minerva chirurgica JID - 0400726 SB - IM MH - Adult MH - Aged MH - *Cholangiopancreatography, Endoscopic Retrograde MH - *Cholecystectomy, Laparoscopic MH - Choledocholithiasis/*surgery MH - Conversion to Open Surgery/statistics & numerical data MH - Female MH - Humans MH - Length of Stay/statistics & numerical data MH - Male MH - Middle Aged MH - Operative Time MH - Postoperative Complications/epidemiology MH - Time Factors EDAT- 2016/12/17 06:00 MHDA- 2018/01/03 06:00 CRDT- 2016/12/17 06:00 PHST- 2016/12/17 06:00 [pubmed] PHST- 2018/01/03 06:00 [medline] PHST- 2016/12/17 06:00 [entrez] AID - S0026473316072485 [pii] AID - 10.23736/S0026-4733.16.07248-5 [doi] PST - ppublish SO - Minerva Chir. 2017 Apr;72(2):98-102. doi: 10.23736/S0026-4733.16.07248-5. Epub 2016 Dec 16.