Combined laparoendoscopic approach for biliary lithiasis treatment.
OBJECTIVE
The treatment of common bile duct stones diagnosed during videolaparoscopic cholecystectomy is still under debate. In cases of suspected common bile duct stones, a double approach with endoscopic retrograde cholangiopancreatography either prior to, or following videolaparoscopic cholecystectomy is the current routine in many centers. An intraoperative endoscopic retrograde cholangiopancreatography with endoscopic papillosphincterotomy and stone extraction has recently been proposed.


METHODS
We compared the approaches for suspected common bile duct stones in 21 cases of combined intervention endoscopic retrograde cholangiopancreatography during videolaparoscopic cholecystectomy to 17 cases of sequential intervention (endoscopic retrograde cholangiopancreatography prior to videolaparoscopic cholecystectomy). Complications and postoperative monitoring are discussed and reported on the basis of hospital stay.


RESULTS
Although the efficacy and the complications are similar, patients treated with the sequential approach stayed in the hospital longer because of the double monitoring period during both after endoscopic retrograde cholangiopancreatography and after videolaparoscopic cholecystectomy.


CONCLUSIONS
A combined approach to suspected common bile duct stones during videolaparoscopic cholecystectomy could be an effective and a financially worthwhile treatment.
Filauro
M
M
I UO Chirurgia Generale, Ospedali Galliera, Genova, Italy.
Comes
P
P
De Conca
V
V
Coccia
G
G
Prandi
M
M
Bagarolo
C
C
Marini
P
P
Anfossi
A
A
D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D042882:Gallstones / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*