Laparoendoscopic Rendezvous Procedure for Cholecysto-choledocholithiasis: Relevance of Anterograde Duodenum Guidewire Placement in Outcomes: A Single Series of 389 Cases from a Teaching Hospital in Santiago, Chile

Introduction: The ideal management for colecysto-choledocholithiasis remains controversial. One-stage approach using a laparoendoscopic “Rendez Vous” (LERV) technique could offer some advantages over the two-stage approach, mainly by reducing complications and costs. aim of this study is to describe implementation LERV its perioperative outcomes. Methods: Retrospective study. All patients with cholecysto-choledocholithiasis that underwent cholecystectomy ERCP in one anesthetic session at teaching hospital Santiago, Chile, between January 2010 2020, were included. Both elective emergency cases where was attempted analyzed. Results: A total 389 identified. In 79% (309/389) patients, achieved placing guidewire through cystic duct into duodenum. When anterograde placement failed, an intraoperative done. CBD cannulation rate 99.5% (387/389) clearance 90% (350/389). Overall morbidity 11.3% (44/389); 6.9% surgical (post-ERCP pancreatitis duodenal perforation rates 1.8% 0.5%, respectively). analysis showed lower group compared not (p=0.02). Particularly, latter two perforations reported. required exclusion, died because severe sepsis. Conclusion: procedure demonstrated be safe feasible tool treating cholecysto-choledocholithiasis. There significantly placed Intraoperative/postoperative outcomesTabled 1Failed biliary cannulation, n (%)2 (0.5%)0 (0%)2 (2,5%)0.005Successful clearance, (%)350 (90%)283 (91.6%)67 (83.8%)0.038Overall complications, (%)44 (11.3%)31 (10%)13 (16.2%)0.118Surgical complicactions, (%)27 (6.9%)17 (5.5%)10 (12.5%)0.028 Post pancreatitis, (%)7 (1.8%)6 (1.9%)1 (1.2%)0.678 Papilla bleeding, (%)5 (1.3%)4 (1.3%)1 (1.2%)0.975 Duodenal perforation, (2.5%)0.005 Cholangitis, (%)4 (1%)4 (1.4%)0 (0%)0.306 Abdominal abscess, (1%)2 (0.6%)2 (2.5%)0.143Choleperitonitis, (%)3 (0.8%)1 (0.3%)2 (2.5%)0.047 Open table new tab