A new type of rendezvous: Introduction of laparo-endoscopy in selected patients

OBJECTIVE: The aim of this work is to demonstrate the introduction of laparo-endoscopy and to investigate the year-long experience with its use. PATIENTS AND METHODS: In a subgroup of patients with cholecystolithiasis, concomitant lithiasis of the common bile duct may also be present. When the preoperative endoscopic cholangiopancreatography, performed as a result of a suspected choledocholithiasis, was unsuccessful, a "rendezvous" ERCP, laparo-endoscopy, is performed. After a survey of the international literature on the method, and a description of its technique, the authors give a review of the cases of their own 10 patients, which were all successful. RESULTS: These findings emphasise the advantages of the new method in a certain subgroup of patients over the conventional, sequential approach (preoperative ERCP followed by laparoscopic cholecystectomy), and also give technical hints obtained during their performance of the operations up to now. CONCLUSIONS: These results underline the importance of team work that involves the cooperation of a gastroenterologist, a surgeon and an anaesthesiologist in the indication, organisation and implementation of the intervention.