title: Endoscopic Sphincterotomy Using the Rendezvous Technique for Choledocholithiasis during Laparoscopic Cholecystectomy: A Case Report.
abstract: A 50-year-old male was examined at another hospital for fever, general fatigue and slight abdominal pain. He was treated with antibiotics and observed. However, his symptoms did not lessen, and laboratory tests revealed liver dysfunction, jaundice and an increased inflammatory response. He was then admitted to our hospital and underwent an abdominal computed tomography scan and magnetic resonance cholangiopancreatography (MRCP), which revealed common bile duct (CBD) stones. He was diagnosed with mild acute cholangitis. As the same time, he was admitted to our hospital and an emergency endoscopic retrograde cholangiopancreatography was performed. Vater papilla opening in the third portion of the duodenum and presence of a peripapillary duodenal diverticulum made it difficult to perform cannulation of the CBD. In addition, MRCP revealed that the CBD was extremely narrow (diameter 5 mm). We therefore performed laparoscopic cholecystectomy and endoscopic sphincterotomy using the rendezvous technique for choledocholithiasis simultaneously rather than laparoscopic CBD exploration. After the operation, the patient was discharged with no complications. Although the rendezvous technique has not been very commonly used because several experts in the technique and a large operating room are required, this technique is a very attractive and effective approach for treating choledocholithiasis, for which endoscopic treatment is difficult.
authors.affiliation: Departments of Surgery, Nagasaki, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Departments of Surgery, Nagasaki, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Haraguchi
authors.affiliation: Departments of Surgery, Nagasaki, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tokai
authors.affiliation: Departments of Surgery, Nagasaki, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ito
authors.affiliation: Departments of Surgery, Nagasaki, Japan.
authors.forename: Masachika
authors.initials: M
authors.lastname: Kitajima
authors.affiliation: Departments of Surgery, Nagasaki, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ohno
authors.affiliation: Departments of Surgery, Nagasaki, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Onizuka
authors.affiliation: Departments of Surgery, Nagasaki, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Departments of Gastroenterology, Nagasaki Harbor Medical Center City Hospital, Nagasaki, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Motoyoshi
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kuroki
authors.affiliation: Departments of Surgery, Nagasaki, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanemastu
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
keywords: Endoscopic sphincterotomy; Laparoscopic cholecystectomy; Rendezvous technique