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Background <p>Common bile duct stones (CBDS) are a common finding during laparoscopic cholecystectomy, yet the optimal treatment strategy remains under debate. In Sweden, CBDS are usually managed by intraoperative endoscopic retrograde cholangiopancreatography using the rendezvous technique (RV–ERCP). An alternative treatment approach is laparoscopic transcystic placement of an endobiliary stent with postoperative ERCP (TCStent–ERCP). The aim of this study was to compare these two treatment strategies in terms of complication rates.</p> Method <p>Data were extracted from the Swedish Registry for Gallstone surgery and ERCP (GallRiks) from three different hospitals between 2010 and 2023. All cholecystectomies in which CBDS were detected intraoperatively and ERCP was carried out, either during the same session or later, were collected. Procedures involving TCStent–ERCP or RV–ERCP were identified. Complications within 30&#xa0;days related to the cholecystectomy as well as to the ERCP were compared between the two groups.</p> Results <p>In total, 929 patients were included. The overall complication rates were 21/183 (11%) in the TCStent–ERCP group and 140/746 (19%) in the RV–ERCP group. In adjusted multivariable regression analysis, fewer overall complications were found using the TCStent–ERCP strategy compared with RV–ERCP (OR 0.60, 95% CI 0.35–0.97). However, no statistically significant differences were observed between the groups for surgical complications or post-procedural pancreatitis.</p> Conclusion <p>Transcystic stenting with postoperative ERCP appears to be a safe alternative to intraoperative rendezvous ERCP for the management of CBDS encountered during intraoperative cholangiography. This might be beneficial in surgical units where resources required for unplanned ERCP are limited or lacking.</p>

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Laparoscopic transcystic stenting with postoperative ERCP for the treatment of common bile duct stones: a safe alternative to intraoperative rendezvous ERCP—Data from the Swedish registry for gallstone surgery and ERCP (GallRiks)

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  • 发表日期：

    2026年1月21日

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  • Sara Johansson,
  • Camilla Runfors,
  • Gabriel Sandblom,
  • Björn Lindkvist,
  • Anders Thorell,
  • Marcus Reuterwall Hansson

摘要

Background

Common bile duct stones (CBDS) are a common finding during laparoscopic cholecystectomy, yet the optimal treatment strategy remains under debate. In Sweden, CBDS are usually managed by intraoperative endoscopic retrograde cholangiopancreatography using the rendezvous technique (RV–ERCP). An alternative treatment approach is laparoscopic transcystic placement of an endobiliary stent with postoperative ERCP (TCStent–ERCP). The aim of this study was to compare these two treatment strategies in terms of complication rates.

Method

Data were extracted from the Swedish Registry for Gallstone surgery and ERCP (GallRiks) from three different hospitals between 2010 and 2023. All cholecystectomies in which CBDS were detected intraoperatively and ERCP was carried out, either during the same session or later, were collected. Procedures involving TCStent–ERCP or RV–ERCP were identified. Complications within 30 days related to the cholecystectomy as well as to the ERCP were compared between the two groups.

Results

In total, 929 patients were included. The overall complication rates were 21/183 (11%) in the TCStent–ERCP group and 140/746 (19%) in the RV–ERCP group. In adjusted multivariable regression analysis, fewer overall complications were found using the TCStent–ERCP strategy compared with RV–ERCP (OR 0.60, 95% CI 0.35–0.97). However, no statistically significant differences were observed between the groups for surgical complications or post-procedural pancreatitis.

Conclusion

Transcystic stenting with postoperative ERCP appears to be a safe alternative to intraoperative rendezvous ERCP for the management of CBDS encountered during intraoperative cholangiography. This might be beneficial in surgical units where resources required for unplanned ERCP are limited or lacking.