Intraoperative Endoscopic Sphincterotomy During Laparoscopic Cholecystectomy

Simultaneous laparoendoscopic rendezvous for the treatment of cholecystocholedocholithiasis

“…The data were collected from 20 original papers reporting studies involving 8 [11] to 93 [26] patients. In addition, another 7 reports of one or a few cases were considered [7,8,10,[31][32][33][34], which collected another 12 patients, allowing us to consider a total of 799 patients. Four patients were excluded by the authors before they attempted the combined treatment, leaving 795 patients [28].…”

“…Feretis et al [9] in 1994 were the only ones to publish the results of laparoscopic transcystic anterograde sphincterotomy with a hydrophilic guidewire for 12 patients using the endoscope alone to control the sphincterotomy. In 1996, Nakajima et al [10] published a technical note pointing out the importance of the transcystic guidewire but reporting also their unsatisfactory experience with the anterograde transcystic sphincterotomy.…”

Intraoperative endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy

“…New instr umentation is being developed and improved continuouosly enabling the endoscopis t-surgeon to deal more and more successfully and creatively with a varity of in tra-abdominal conditions [4][5][6] . But the management of coexisting gallbla dder and CBD stones is now more controversial than before, because many approaches to resolve this problem have their limitations besides the expense: and time (Table 2) [8][9][10][11][12] . From May 1994 to November 1997, 1794 cases of LC and IOC were performed in o ur hospital.…”

“…First, some surgeons in our department thought that IOES presents significant logistic difficulties in coordinating the necessary personnel and equipment. Second, it was thought that the supine position may increase the technical difficulty of EST [8][9][10][11][12] . But in our experience it is easier to remove the CBD stones by a combinati on of LC with IOES than by pre-or postoperative EST.…”

“…The advent of laparoscopic cholecystectomy (LC) in the late 1980s gained widespr ead acceptance within a short period of time and has become the preferred treatment for symptomatic gallstones [1][2][3][4][5][6][7] , but the management of coexisting ga llbladder and common bile duct (CBD) stones has remained controversial because t he various strategies proposed have their limitations [8][9][10][11][12] . In fact, ch oledocholithiasis is found in 10%-15% of patients cholecystolithiasis, and most authors agree that at least 90% of CBD stones are secondary to those of the gallbladder, and that CBD stones must be extracted in timely manner in order to avoid consequent complications which would otherwise occur in at least 90% of patients [1][2][3][4] .…”