title: Intraoperative endoscopist-controlled guide wire cannulation technique sphincterotomy during laparoscopic cholecystectomy.
abstract: BACKGROUND
  Intraoperative endoscopic sphincterotomy (IOES) is considered superior to preoperative endoscopic sphincterotomy and other treatment modalities for management of common bile duct (CBD) stones. Here we describe the method and results of our technique of IOES in the supine position during laparoscopic cholecystectomy (LC) using a guide wire cannulation (intraoperative supine endoscopic sphincterotomy by endoscopist-controlled guide wire cannulation) [ISEEG] technique).
  
  
  METHODS
  This is a retrospective analysis of the outcome for 36 patients undergoing LC with IOES (ISEEG technique) for acute biliary colic and jaundice with suspicion of choledocholithiasis.
  
  
  RESULTS
  On confirmation of CBD stones by intraoperative cholangiogram, CBD catheterization was successful in 34/36 (94.44%) patients with successful stone clearance in all of them by the ISEEG technique demonstrating 100% efficacy for stone clearance; the remaining 2 patients needed conversion to open surgery. The median time for the ISEEG technique during intraoperative sphincterotomy was 9 minutes (range, 7-23 minutes). Average hospital stay was 4.8 days (range, 2-15 days). At the 1-month follow-up, all patients were biliary symptom-free. Three of 36 patients (8.33%) had mild postoperative pancreatitis. There was no procedure-related mortality.
  
  
  CONCLUSIONS
  LC coupled with the ISEEG technique performed by an expert endoscopist is an effective single-stage minimally invasive treatment for CBD stones with good efficacy, good stone clearance rates, and low morbidity.
authors.affiliation: Research Institute Against Digestive Cancer/European Institute of TeleSurgery, Department of Gastrointestinal and Endocrinal Surgery, University of Strasbourg, 1 Place de l'Hôpital, Strasbourg, France. endoscoping@gmail.com
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Donatelli
authors.forename: Parag
authors.initials: P
authors.lastname: Dhumane
authors.forename: Bernard
authors.initials: B
authors.lastname: Dallemagne
authors.forename: Silvana
authors.initials: S
authors.lastname: Perretta
authors.forename: Didier
authors.initials: D
authors.lastname: Mutter
authors.forename: Michel
authors.initials: M
authors.lastname: Delvaux
authors.forename: Michel
authors.initials: M
authors.lastname: Doffoel
authors.forename: Gerard
authors.initials: G
authors.lastname: Gay
authors.forename: Jacques
authors.initials: J
authors.lastname: Marescaux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D055815:Young Adult