Laparoendoscopic Rendezvous for Difficult Cholecystocholedocholithiasis

What this Trial Is About

Gallbladder stones combined with common bile duct stones, known as cholecystocholedocholithiasis, affect a notable number of patients and present challenges in treatment. This study focuses on patients experiencing difficult bile duct cannulation during endoscopic retrograde cholangiopancreatography (ERCP), a key procedure for stone removal. Researchers aim to evaluate the safety and effectiveness of the laparoendoscopic rendezvous (LERV) technique, which combines laparoscopic and endoscopic methods in a single operation to manage this condition. The study involves a single-stage procedure called laparoendoscopic rendezvous, which integrates laparoscopic cholecystectomy with intra-operative endoscopic sphincterotomy and stone removal. The technique includes an antegrade trans-cystic cannulation of the bile duct to aid endoscopic access, followed by stone clearance and the completion of gallbladder removal. The process has three main steps: the laparoscopic phase, the endoscopic phase, and completion. The study compares this approach against the traditional two-stage method involving pre-operative endoscopic sphincterotomy followed by laparoscopic cholecystectomy. Participants will undergo assessments during and after the procedure, including monitoring for successful bile duct cannulation, stone clearance, and complications such as pancreatitis, bleeding, bile leaks, perforation, cholangitis, and bile duct strictures. Follow-ups will assess short-term and long-term outcomes up to one year after the procedure. The study aims to provide detailed information on the effectiveness and safety of the laparoendoscopic rendezvous technique for treating difficult cholecystocholedocholithiasis.

Laparoendoscopic Rendezvous for Concomitant Gall Bladder Stones and Common Bile Duct Stones