Laparoendoscopic Rendezvous Versus Preoperative ERCP and Laparoscopic Cholecystectomy for the Management of Cholecysto-Choledocholithiasis
作者： George Tzovaras , Ioannis Baloyiannis , Eleni Zachari , Dimitris Symeonidis , Dimitris Zacharoulis
DOI: 10.1097/SLA.0B013E3182456EC0
关键词:
摘要: Background Although the ideal management of cholecysto-choledocholi-thiasis is controversial, 2-stage approach [endoscopic retrograde cholangiopancreatography (ERCP), sphincterotomy, and common bile duct (CBD) clearance followed by laparoscopic cholecystectomy] remains standard way worldwide. One-stage using so-called laparoendoscopic rendezvous (LERV) technique offers some advantages, mainly reducing hospital stay risk post-ERCP pancreatitis. Objective To compare LERV 1-stage with consisting preoperative ERCP cholecystectomy for treatment cholecysto-choledocholithiasis. Setting Controlled randomized trial, University/Teaching Hospital. Methods : Patients cholecysto-choledocholithiasis were either to or approach. Both elective emergency cases included in study. Primary endpoint was detect difference overall stay, whereas secondary endpoints (i) differences morbidity (especially pancreatitis) (ii) success CBD clearance. This an interim analysis first 100 patients. Results Hospital significantly shorter group; median 4 (2-19) days versus 5.5 (3-22) days, P = 0.0004. There no between 2 groups. Post-ERCP amylase value found lower group: 65 (16-1159) 91 (30-1846), 0.02. Conclusions Interim results suggests superiority terms hyperamylasemia.
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