EXPERIENCE WITH LAPAROENDOSCOPIC RENDEZ-VOUS APPROACH IN A SINGLE TIME MANAGEMENT OF VESICULAR LITHIASIS AND CHOLEDOCHOLITHIASIS

Abstract

We describe the first experience using laparoendoscopic “rendez-vous” approach in the management of patients diagnosed with simultaneous cholecystolithiasis and choledocholithiasis at General Surgery Department of “Hospital Universitario de Caracas”. Method: Eight patients diagnosed with simultaneous cholecystolithiasis and choledocholithiasis underwent elective laparoendoscopic “rendez-vous” approach. Results: Intraoperative cholangiography confirmed choledocholithiasis in four patients (57%), lithiasis were successfully extracted on three of them (75%) using intraoperative endoscopic retrograde cholangiography after transcystic insertion of a guide wire to reach Vater‘s papilla. No post endoscopic
retrograde cholangiography pacreatitis or residual common ductal stones were reported after a 3 months follow. Mean hospital stay was 9.75 days (2-25 days), and mean post operatory stay was 2.87 days (1-7 days). Conclusion: Rendez-vous approach is a minimal invasive, safe and effective choice available to the management of patients diagnosed with simultaneous cholecystolithiasis and choledocholithiasis, which is performed in a single anesthesia, needs a short hospital stay and lowers ERC complications.