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.
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Surg Endosc
January 2025
Department of General Surgery, Fiona Stanley Hospital, 11 Robin Warren Dr, Murdoch, WA, Australia.
Background: Laparoscopic cholecystectomy is the preferred treatment for symptomatic cholelithiasis and acute cholecystitis, with increasing applications even in severe cases. However, the possibility of postoperative endoscopic retrograde cholangiopancreatography (ERCP) to manage choledocholithiasis or biliary injuries poses significant clinical challenges. This study aimed to develop a predictive model for ERCP incidence following emergency laparoscopic cholecystectomy using advanced machine learning techniques.
View Article and Find Full Text PDFCureus
December 2024
Surgery, Memorial University of Newfoundland, St. John's, CAN.
Concurrent malignant biliary and gastric outlet obstruction requires urgent palliative intervention to improve patient quality of life and permit systemic therapy. Traditional management has been surgical gastrojejunostomy and hepaticojejunostomy, two morbid procedures. Comparatively, endoscopic stenting can relieve both sites of obstruction with less complications and quicker recovery.
View Article and Find Full Text PDFHeliyon
January 2025
Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing, 100073, China.
Background: Super-elderly patients with choledocholithiasis are considered to be at high risk for undergoing surgery. While laparoscopic transcystic common bile duct exploration (LTCBDE) is regarded as a challenging procedure for super-elderly patients with choledocholithiasis, there have been no reported cases of its use in super-elderly patients over the age of 96.
Case Summary: This case study presents the case of a 96-year-old female patient with acute calculous cholecystitis and choledocholithiasis.
BMC Gastroenterol
January 2025
Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No.17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Background: Endoscopic gallbladder-preserving cholecystolithotomy (EGPC) has become an alternative option for treating cholecystolithiasis. However, developing a new method of EGPC in which the gallbladder wall is not damaged remains a challenge. This study introduced a new EGPC method called endoscopic retrograde cholangiopancreatography (ERCP) combined with extracorporeal shock wave lithotripsy (ESWL), which preserves the integrity of the gallbladder wall in the treatment of cholecystolithiasis complicated with choledocholithiasis.
View Article and Find Full Text PDFFront Med (Lausanne)
December 2024
Department of General Surgery, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China.
Background: Special attention should be given to intra-abdominal adhesions in patients with a history of open cholecystectomy for gallstones or abdominal surgery. Choosing the appropriate surgical approach to remove the stones is crucial.
Patient Summary: A 68-year-old male was admitted due to sudden onset of upper abdominal pain lasting more than 6 h.
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