Kreve Fernanda, Takada Jonas, Gatto Janaina, Loss Francisco S, Artifon Everson L A
Medical School Academic, Centro Universitário Fundação Assis Gurgacz. Cascavel, Brazil.
Departmentof Surgery, University of Sao Paulo. Sao Paulo, Brazil.
Rev Gastroenterol Peru. 2017 Apr-Jun;37(2):165-168.
The choice treatment for choledocholithiasis when associated with lithiasic cholecystitis is endoscopic retrograde cholangiopancreatography (ERCP). However, in some cases this therapeutic fails, which requires an alternative method to extract the stones. The surgical approach tends to be the next step, but it is related to greater complexity of achievement and higher complications rates. In 1993, Deslandres et al. developed the combined treatment called laparoendoscopic rendez-vous, that unites in a single stage the endoscopic treatment of choledocholithiasis and laparoscopic removal of the gallbladder. We report the case of a patient diagnosed with common bile duct (CBD) stones, in which the conventional CPRE was not successful, and was taken to treatment by laparoendoscopic approach. We conclude, based on this case and on other published studies, that this therapeutic modality has advantages for being feasible, presenting low complications rate, shorter hospital stay and acceptable cost.
胆总管结石合并结石性胆囊炎时，内镜逆行胰胆管造影术（ERCP）是首选治疗方法。然而，在某些情况下，这种治疗方法会失败，这就需要采用替代方法来取出结石。手术方法往往是下一步选择，但它涉及到更高的操作复杂性和更高的并发症发生率。1993年，德斯兰德斯等人开发了一种联合治疗方法，称为腹腔镜内镜会师术，该方法在一个阶段内将胆总管结石的内镜治疗与腹腔镜胆囊切除术结合起来。我们报告了一例被诊断为胆总管结石的患者，其常规ERCP治疗未成功，随后采用腹腔镜内镜方法进行治疗。基于该病例和其他已发表的研究，我们得出结论，这种治疗方式具有可行性、并发症发生率低、住院时间短和成本可接受等优点。
