El-Geidie Ahmed Abdel-Raouf
Gastroenterology Surgical Center, Jehan st, Mansoura University, Mansoura, Dakahlia, Egypt.
Surg Laparosc Endosc Percutan Tech. 2011 Aug;21(4):282-7. doi: 10.1097/SLE.0b013e3182218908.
The intraoperative use of endoscopic retrograde cholangiopancreatography (ERCP) during laparoscopic cholecystectomy (LC) is a safe, single-stage option for the management of concomitant gallstones (GS) and common bile duct stones (CBDS). This study aims to compare between 2 techniques of combined laparoendoscopic management, which are laparoendoscopic Rendez-vous (LC/LERV) technique and standard ERCP after the completion of LC intraoperative endoscopic sphincterotomy (IOES).
Patients with GS and suspected CBDS were included. They were divided into 2 groups; LC/LERV and LC/IOES. Both groups were compared for failure of endoscopic sphincterotomy/stone extraction, operative time, conversion rate, mortality/morbidity, and length of hospital stay.
Between October 2007 and February 2010, 98 patients with GS and CBDS were eligible for inclusion in the study. They were prospectively randomized into 2 groups; LC/LERV (N=45) and LC/IOES (N=53). There were no differences in preoperative parameters between both groups. There was a significant difference in operative time (shorter for LC/IOES). No difference was noted in success/failure rate, post-ERCP pancreatitis.
Both Standard ERCP after the completion of LC and LC/LERV are valid single-session management for CBD stones, but LC-ERCP may be preferred.
在腹腔镜胆囊切除术（LC）期间术中使用内镜逆行胰胆管造影术（ERCP）是一种安全的单阶段方法，用于处理合并存在的胆结石（GS）和胆总管结石（CBDS）。本研究旨在比较两种联合腹腔镜内镜治疗技术，即腹腔镜内镜会师术（LC/LERV）技术和在LC完成后进行术中内镜括约肌切开术（IOES）后的标准ERCP。
纳入患有GS且怀疑有CBDS的患者。他们被分为两组；LC/LERV组和LC/IOES组。比较两组在内镜括约肌切开术/结石取出失败率、手术时间、中转率、死亡率/发病率以及住院时间方面的差异。
在2007年10月至2010年2月期间，98例患有GS和CBDS的患者符合纳入本研究的条件。他们被前瞻性随机分为两组；LC/LERV组（N = 45）和LC/IOES组（N = 53）。两组术前参数无差异。手术时间存在显著差异（LC/IOES组较短）。在成功/失败率、ERCP术后胰腺炎方面未发现差异。
LC完成后进行的标准ERCP和LC/LERV都是处理CBD结石的有效的单阶段治疗方法，但LC - ERCP可能更受青睐。
