title: Laparo-endoscopic rendez-vous versus sequential "delayed" approach in patients with choledocholithiasis.
abstract: BACKGROUND
  The aim of this study was to compare the efficacy and safety of synchronous laparoscopic cholecystectomy with laparo-endoscopic rendez-vous (LRV) technique vs. sequential "delayed" approach with the main goal to compare the conversion rate and postoperative complications.
  
  
  METHODS
  Patients diagnosed as having gallstones and CBD stones or sludge were enrolled in this study. From January 2013 to June 2015, 43 consecutive patients were submitted to the sequential treatment (ERCP prior to laparoscopic cholecystectomy) and the next consecutive 46 patients were submitted to undergo the rendez-vous technique. All endoscopic procedures in both groups were performed by the same endoscopist with the same technique. Data were collected on patient age, gender, latency operation time, duration of surgery, bilio-pancreatic events, hospital stay, mortality, conversion rate and postoperative complications.
  
  
  RESULTS
  The overall mean age was 58 years-old (25-84 years) with 43 males (48.3%) and 46 females (51.7%). The conversion rate to open surgery was 11.6% in the "sequential group" vs. 2.2% in the LRV group with a P value 0.10. The reasons for conversion included in the first group unclear anatomy (in 2 patients) and severe adhesions (in the remnant 3 patient), and in the second group unclear anatomy (in one patient). No bilio-pancreatic events occurred in the waiting period for LC in the first group. No mortality was recorded in either group. Postoperative complications were seen in 7% of patients in the "sequential group" vs. 2.2% in the rendez-vous group (P value 0.35).
  
  
  CONCLUSIONS
  LRV does not present real advantages in comparison to delayed sequential approach in terms of conversion rate and postoperative complications. However, these results require further elaboration in studies on large numbers of patients undergoing LRV approach.
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies &quot;G.F. Ingrassia&quot;, University of Catania, Catania, Italy - nino.fish@hotmail.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pesce
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies &quot;G.F. Ingrassia&quot;, University of Catania, Catania, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: LA Greca
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies &quot;G.F. Ingrassia&quot;, University of Catania, Catania, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Latteri
authors.affiliation: Policlinic Hospital &quot;G. Rodolico&quot;, Catania, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Guardabasso
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies &quot;G.F. Ingrassia&quot;, University of Catania, Catania, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: DI Marco
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies &quot;G.F. Ingrassia&quot;, University of Catania, Catania, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: DI Blasi
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies &quot;G.F. Ingrassia&quot;, University of Catania, Catania, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Russello
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies &quot;G.F. Ingrassia&quot;, University of Catania, Catania, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Puleo
mesh_terms: D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D042883:Choledocholithiasis / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors