The Rendezvous Technique for the Removal of Common Bile Duct Stones
The Rendezvous Technique for the Removal of Common Bile Duct Stones
Borzellino G, Rodella L, Saladino E, et al
Arch Surg. 2010;145:1145-1149
Can common bile duct stones be removed safely and successfully at the time of laparoscopic cholecystectomy using intraoperative endoscopy? The authors reported their results from a 2-team approach in 110 unselected patients. The surgical team performed routine laparoscopic cholecystectomy, and if common bile duct stones were detected, a second endoscopic team was called in to remove the common duct stones via a transduodenal approach. Insertion of a guidewire by the surgical team helped the endoscopists. The complication rate was 3.7% and 1 death resulted from post-endoscopic retrograde cholangiopancreatography pancreatitis.
Many different approaches are available for the management of choledocholithiasis detected at the time of laparoscopic cholecystectomy. The combined "rendezvous" technique requires careful coordination between the surgical team and the endoscopic team, and increases both the length and complexity of the procedure. In an accompanying editorial, Ellison pointed out that most surgeons prefer a 2-stage approach to managing this problem and consider it to be equally effective, equally safe, and less disruptive to the operative schedule.
Abstract
Treatment for Retrieved Common Bile Duct Stones During Laparoscopic Cholecystectomy: The Rendezvous Technique
Borzellino G, Rodella L, Saladino E, et al
Arch Surg. 2010;145:1145-1149
Summary
Can common bile duct stones be removed safely and successfully at the time of laparoscopic cholecystectomy using intraoperative endoscopy? The authors reported their results from a 2-team approach in 110 unselected patients. The surgical team performed routine laparoscopic cholecystectomy, and if common bile duct stones were detected, a second endoscopic team was called in to remove the common duct stones via a transduodenal approach. Insertion of a guidewire by the surgical team helped the endoscopists. The complication rate was 3.7% and 1 death resulted from post-endoscopic retrograde cholangiopancreatography pancreatitis.
Viewpoint
Many different approaches are available for the management of choledocholithiasis detected at the time of laparoscopic cholecystectomy. The combined "rendezvous" technique requires careful coordination between the surgical team and the endoscopic team, and increases both the length and complexity of the procedure. In an accompanying editorial, Ellison pointed out that most surgeons prefer a 2-stage approach to managing this problem and consider it to be equally effective, equally safe, and less disruptive to the operative schedule.
Abstract