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Chirurgia 2001 June-August;14(3-4):129-32

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

Same-Session endoscopic retrograde colangiopancreatography and laparoscopic cholecystectomy

Nistri R., Vitali A., Basili G., Carrieri P., Nucci A., Chibbaro G.


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Background. Laparoscopic cholecystectomy has been the gold standard for the treatment of gallbladder calculi for a number of years. The introduction of this new technique, leading to the gradual phasing-out of intraoperative colangiography has meant that some common bile duct calculi have been misdiagnosed. Even when common bile duct calculi are identified, opinions vary as to the choice of therapy. The authors illustrate the results of combined laparoscopic cholecystectomy and endoscopic papillotomy performed simultaneously without altering the patient's position on the operating table.
Methods. Intraoperative colangiography was carried out in 121 patients, identifying 12 cases of patients with common bile duct calculi; in 3 of these patients, laparoscopic surgery was converted into traditional open papillotomy, whereas the remaining 8 patients underwent combined laparoscopic cholecystectomy+ endoscopic papillotomy without altering the patient's position.
Results. The results of the combined laparo-endoscopic surgery were good, also because of the lack of complications. The operation was normal in all cases and all 8 patients were discharged by day 4 after surgery.
Conclusions. In terms of patient acceptance, this treatment was extremely advantageous, also because patients were able to leave hospital within 3-4 days. From a strictly internal point of view, it is not very cost-effective because it requires more time and organisation.

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