Author:Morino M, Baracchi F, Miglietta C, Furlan N, Ragona R, Garbarini A.
Resource: Ann Surg. 2006 Dec;244:889-93; discussion 893-6
Abstract: OBJECTIVE: To compare success rate, length of hospital stay, clinical results, and costs of sequential treatment (endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy) versus the laparoendoscopic Rendezvous in patients with cholecysto-choledocholithiasis. BACKGROUND: The ideal management of common bile duct (CBD) stones in the era of laparoscopic cholecystectomy (LC) remains controversial. METHODS: A total of 91 elective patients with cholelithiasis and CBD stones diagnosed at magnetic resonance cholangiography (MRC) were included in a prospective, randomized trial. The patients were randomized in 2 groups. Group I patients (45 cases) underwent a preoperative endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) followed by LC in the same hospital admission. Group II patients (46 cases) underwent LC associated with intraoperative ERCP and ES according to the rendezvous technique. RESULTS: The rate of CBD clearance was 80% for Group I and 95.6% for Group II (P = 0.06). The morbidity rate was 8.8% in Group I and 6.5% in Group II (P = not significant). No deaths occurred in either group. Hospital stay was shorter in Group II than in Group I: 4.3 days versus 8.0 days (P < 0.0001). There was a significant reduction in mean total cost for group II patients versus group I patients: 2829 euro versus 3834 euro (P < 0.05). CONCLUSIONS: When compared with preoperative ERCP with ES followed by LC, the laparoendoscopic rendezvous technique allows a higher rate of CBD stones clearance, a shorter hospital stay, and a reduction in costs.
PMID:17122614
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Title: Preoperative endoscopic sphincterotomy versus laparoendoscopic rendezvous in patients with gallbladder and bile duct stones.
标题：术前EST与腹腔镜联合术中EST治疗胆囊和胆总管结石的随机对照研究
Author:Morino M, Baracchi F, Miglietta C, Furlan N, Ragona R, Garbarini A.
作者：Morino M, Baracchi F, Miglietta C, Furlan N, Ragona R, Garbarini A.
Resource: Ann Surg. 2006 Dec;244:889-93; discussion 893-6
文章来源：外科年报.2006十二月；244：889-93;结论893-6
Abstract: OBJECTIVE: To compare success rate, length of hospital stay, clinical results, and costs of sequential treatment (endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy) versus the laparoendoscopic Rendezvous in patients with cholecysto-choledocholithiasis.
摘要：
目的：
为了比较顺序治疗（在内窥镜逆行胰胆管造影术后进行腹腔镜胆囊切除术）与腹腔镜联合术在治疗胆囊-胆总管结石时的成功率、住院时间、临床结果和费用。
BACKGROUND: The ideal management of common bile duct (CBD) stones in the era of laparoscopic cholecystectomy (LC) remains controversial.
背景：对总胆管结石的理想治疗，在腹腔镜胆囊切除术(LC)时代尚有争议。
METHODS: A total of 91 elective patients with cholelithiasis and CBD stones diagnosed at magnetic resonance cholangiography (MRC) were included in a prospective, randomized trial.
方法：总共有91名经磁共振胆管造影术中检查有胆结石及胆总管结石的患者纳入一项前瞻性随机试验。
The patients were randomized in 2 groups.
患者被随机分成2组。
Group I patients (45 cases) underwent a preoperative endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) followed by LC in the same hospital admission.
组I患者（45例）在同一家医院，在进行LC前行术前内窥镜逆行胰胆管造影术(ERCP)及内窥镜括约肌切开术(ES)。
Group II patients (46 cases) underwent LC associated with intraoperative ERCP and ES according to the rendezvous technique.
组II患者（46例）根据联合术技术行LC联合ERCP和ES术。
RESULTS: The rate of CBD clearance was 80% for Group I and 95.6% for Group II (P = 0.06). The morbidity rate was 8.8% in Group I and 6.5% in Group II (P = not significant). No deaths occurred in either group.
结果：CBD清除率，组I为80%，组II为95.6% (P = 0.06)。结石复发率，组I为8.8%，组II为6.5%(P不显著)。两组均无死亡例。
Hospital stay was shorter in Group II than in Group I: 4.3 days versus 8.0 days (P < 0.0001). There was a significant reduction in mean total cost for group II patients versus group I patients: 2829 euro versus 3834 euro (P < 0.05).
住院时间，组II比组I短：4.3天：8.0天(P < 0.0001)。平均总花费，组II比组I明显减少：2829 euro：3834 euro (P < 0.05)。
CONCLUSIONS: When compared with preoperative ERCP with ES followed by LC, the laparoendoscopic rendezvous technique allows a higher rate of CBD stones clearance, a shorter hospital stay, and a reduction in costs.
结论：与LC术前进行ERCP 和ES相比，腹腔镜联合术对CBD结石的清除率更高，住院时间更短，费用更少。
PMID:17122614
编译：（中文字符：385）
在腹腔镜胆囊切除术(LC)时代对总胆管结石的理想治疗方法尚存有争议。为了比较顺序治疗（在内窥镜逆行胰胆管造影术后进行腹腔镜胆囊切除术）与腹腔镜联合术在治疗胆囊-胆总管结石时的成功率、住院时间、临床效果及费用，Morino M等研究人员对术前EST和腹腔镜联合术中EST治疗胆囊和胆总管结石进行了随机对照研究。（Ann Surg. 2006 Dec;244:889-93; discussion 893-6）
此前瞻性随机试验总共纳入91名经磁共振胆管造影术检查出有胆结石及胆总管结石的患者。患者被随机分成2组。组I患者（45例）于同一家医院在进行LC前行术前内窥镜逆行胰胆管造影术(ERCP)及内窥镜括约肌切开术(ES)。组II患者（46例）根据联合术技术行LC联合ERCP和ES术。结果发现，CBD清除率，组I为80%，组II为95.6% (P = 0.06)。结石复发率，组I为8.8%，组II为6.5%(P不显著)。两组均无死亡例。住院时间，组II比组I短，为4.3天：8.0天(P < 0.0001)。平均总花费，组II比组I明显减少，2829 euro：3834 euro (P < 0.05)。由此得出结论，与LC术前行ERCP 和ES相比，腹腔镜联合术对CBD结石的清除率更高，住院时间更短，费用更少。（丁香）
该技术应该仅可能地广泛推广,这样有利于病人,对CBD结石的清除率更高，住院时间更短，费用更少。
我们只要在手术室增加一台胃肠X线机就可以解决问题了.