LAUSR

Gallstone diseases, affecting up to 20% of European population, frequently results in hospitalization due to conditions such as cholecystitis, cholangitis, and pancreatitis. Treatment involves laparoscopic cholecystectomy (LC) and/or endoscopic retrograde cholangiopancreatography (ERCP). Failure to cannulate the papilla Vateri during ERCP or inadvertent pancreatic duct cannulation could lead to post-ERCP pancreatitis (PEP), occurring in 3-15%. An alternative method is intraoperative ERCP with rendezvous cannulation, using a guidewire inserted through the cystic duct, which could facilitate the access. Present study aims to investigate the post-operative complications of intraoperative ERCP with rendezvous cannulation compared to ERCP without rendezvous technique. Patients that underwent laparoscopic cholecystectomy and ERCP due to gallstone diseases between 2013-01-01 and 2022-12-31 were analyzed. Data was collected retrospectively from medical records covering variables such as demographic data, indication, cannulation technique, duration of surgery, and complications. Complications were defined as PEP, cholangitis, bleeding, and perforation. 359 patients were identified with 386 ERCPs performed. There were 240 with rendezvous technique and 146 without. 58 patients with pancreatitis as indication of ERCP were excluded from the “PEP”-group, leaving 203 with rendezvous and 124 without. 23 with cholangitis in the “cholangitis”-group were excluded, leaving 226 with and 138 without. Of a total of 58 complications there were 39.7% PEP (n=23), 8.6% cholangitis (n=5), 41.4% bleeding (n=24) and 10.3% perforations (n=6). Using rendezvous technique during ERCP reduces the risk of PEP from 13.3% to 2.97%, as compared to conventional cannulation during ERCP (OR 0.19, 95% CI 0.07-0.5, P <0.001).