ERCP and laparoscopic cholecystectomy in a combined (one-step) procedure with a novel technique

Background

This study compared the benefit of the novel one- step procedure for the managment of calculous biliary disease.

Methods

A retrospective review of 25 geriatric patients was conducted one-step procedure with positionament of loop in digiuno for reductions a little bowel distenction. In 24 of the patients, the one-step technique was successful (96 %); in the remaining 1 patient (4%), conversion open technique was necessary; in this case not positionament of loop in jejunum. We define the one-step procedure to be a laparoscopic cholecystectomy whit IOC to confirm the presence of stone, to be a gold standard; intraoperative ERCP whit stone extraction was conected if necessary as part of the one-step procedure.

Result

This technique evidence a statistically significant difference of the hospital cost, such us the length of the stay and pre operative day and reduce the high conversion rate with alternatively technique in two-step. The incidence of overall complications was lower in the one-step technique. The findings showed that one-step technique was associated with less clinical pancreatitis respect at the two-stage technique.

Conclusion

A laparoscopic cholecystectomy after ES is lengthier and more difficult then in uncomplicated cholelithiasis and should therefore be performed by an experienced surgeon. This new technique appears to be a significant conversion reduction versus two step procedure, and reduce the cost of hospitality and length of stay and preoperative days. Further research with a larger study population is necessary to determine the additional benefits of this procedure.