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Background <p>Laparoscopy-assisted transgastric rendezvous ERCP (LAERCP) is a perioperative treatment option for common bile duct stones (CBDS) in Roux-en-Y gastric bypass (RYGB) patients. Although rendezvous ERCP (RV-ERCP) is a safe treatment for CBDS, comparative data with LAERCP in larger cohorts are lacking. This study compares outcomes of laparoscopic cholecystectomy (LC) and LAERCP in RYGB patients with LC and rendezvous ERCP (RV-ERCP) in patients with unaltered anatomy, using an extensive validated national registry.</p> Methods <p>A retrospective study on prospectively collected nationwide cohort data from the Swedish Registry of Gallstone Surgery and ERCP (GallRiks), including all patients from September 2016 to June 2021 who underwent LC with same-day rendezvous ERCP. Patients with prior RYGB (RYGB group) were compared to those without previous upper abdominal surgery (non-RYGB group). Outcome measures was therapeutic success, peri- and postoperative adverse events, procedural time and readmissions.</p> Results <p>Seventy RYGB and 4342 non-RYGB patients were identified. CBDS were detected in 60 and 3067 patients, respectively. Therapeutic success was 100% in the RYGB group versus 91.4% in the non-RYGB group (<i>p</i> = 0.018). Perioperative adverse events occurred in 8.8% and 2.3% of cases (<i>p</i> &lt; 0.001), but none in the RYGB group had postoperative consequences. Postoperative adverse events, antibiotic use and readmissions were similar. Median procedural time (180 vs. 131&#xa0;min, <i>p</i> &lt; 0.001) and hospital stay (2 vs. 1&#xa0;days, <i>p</i> &lt; 0.001) were longer for the RYGB group. No mortality occurred in either group.</p> Conclusions <p>Concomitant rendezvous LAERCP during LC is a safe and effective method for managing CBDS after RYGB. Despite a higher rate of perioperative events, outcomes were favorable relative to previously published data for non-concomitant LAERCP. These findings support LAERCP with rendezvous technique as the standard of care for RYGB patients in Sweden and provide registry-based evidence to inform future international guidelines.</p>

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Laparoscopic cholecystectomy with laparoscopy-assisted transgastric rendezvous ERCP in gastric bypass patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月12日

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  • Sofia Liljegard,
  • Per-Anders Larsson,
  • Erik Haraldsson

摘要

Background

Laparoscopy-assisted transgastric rendezvous ERCP (LAERCP) is a perioperative treatment option for common bile duct stones (CBDS) in Roux-en-Y gastric bypass (RYGB) patients. Although rendezvous ERCP (RV-ERCP) is a safe treatment for CBDS, comparative data with LAERCP in larger cohorts are lacking. This study compares outcomes of laparoscopic cholecystectomy (LC) and LAERCP in RYGB patients with LC and rendezvous ERCP (RV-ERCP) in patients with unaltered anatomy, using an extensive validated national registry.

Methods

A retrospective study on prospectively collected nationwide cohort data from the Swedish Registry of Gallstone Surgery and ERCP (GallRiks), including all patients from September 2016 to June 2021 who underwent LC with same-day rendezvous ERCP. Patients with prior RYGB (RYGB group) were compared to those without previous upper abdominal surgery (non-RYGB group). Outcome measures was therapeutic success, peri- and postoperative adverse events, procedural time and readmissions.

Results

Seventy RYGB and 4342 non-RYGB patients were identified. CBDS were detected in 60 and 3067 patients, respectively. Therapeutic success was 100% in the RYGB group versus 91.4% in the non-RYGB group (p = 0.018). Perioperative adverse events occurred in 8.8% and 2.3% of cases (p < 0.001), but none in the RYGB group had postoperative consequences. Postoperative adverse events, antibiotic use and readmissions were similar. Median procedural time (180 vs. 131 min, p < 0.001) and hospital stay (2 vs. 1 days, p < 0.001) were longer for the RYGB group. No mortality occurred in either group.

Conclusions

Concomitant rendezvous LAERCP during LC is a safe and effective method for managing CBDS after RYGB. Despite a higher rate of perioperative events, outcomes were favorable relative to previously published data for non-concomitant LAERCP. These findings support LAERCP with rendezvous technique as the standard of care for RYGB patients in Sweden and provide registry-based evidence to inform future international guidelines.