1,2,3,4,5,6,7 Aster Hospital, Mankhool, Dubai-UAE
Author Note
The authors have declared no conflict of interest.
Corresponding Author
Dr. Amal Premchandra Upadhyay, Consultant-Gastroenterology, Aster hospital Mankhool, Dubai. Email: dramal.upadhyay@asterhospital.com
Keywords
Acute cholecystitis, pancreatitis, CBD calculus, laparoscopic cholecystectomy, Rendezvous ERCP, traditional ERCP.
Study design
Retrospective, non-randomized, observational, using historical control subjects.
Study population
Twenty-five consecutive patients with gallbladder and CBD calculi, for whom both ERCP and LC were considered clinically indicated, were recommended to receive joint LC and IOR-ERCP. Detailed informed consent was taken for both procedures. Their outcomes were compared with an equivalent number of patients who underwent conventional management.
ABSTRACT
This case series compares the traditional approach of endoscopic retrograde cholangiopancreatography (ERCP) with separate laparoscopic cholecystectomy (LC), versus combined LC and intra-operative rendezvous ERCP (IOR-ERCP). We consider the costs and benefits of each approach in terms of applicability, efficacy, safety, cost effectiveness and duration of hospital stay.
25 patients with cholelithiasis and choledocholithiasis were selected for laparoscopic
cholecystectomy (LC) and IOR-ER-CP. Informed consent was obtained. A laparoscopic surgeon performed cholecystectomy and a gastroenterologist performed ERCP during the same anaesthesia.
Rendezvous ERCP was successfully completed in 22 of 25 patients. The Rendezvous procedure could not be accomplished in 3 patients due to difficulty passing the guide wire from the cystic duct to the duodenum. One patient had a tortuous cystic duct, another had abnormal connection of the cystic duct to the right hepatic duct and the third had malignancy of the gallbladder occluding the connection with the common
