Laparo-endoscopic “Rendezvous” to treat cholecysto-choledocolithiasis: Effective, safe and simplifies the endoscopist’s work

Table 1 Main differences for the endoscopist between the main steps of endoscopic procedures at the papilla of Vater for CBD exploration comparing RV with standard ERCP-ES

Factors of difference of the endoscopic procedure	RV	ERCP-ES
(1) Position of the patient	Supine	Lateral
	Rarely more difficult endoscopy	Preferred because of habit
(2) Cholangiography	Antegrade transcystic	Retrograde
	Positive (time reduction)	Negative
(3) Wirsung injection (chemical damage)	Absent	Possible
	Positive (risk reduction)	Negative
(4) Ductal hyperpression (physical damage)	Absent	Frequent
	Positive (risk reduction)	Negative
(5) Guide wire help for papilla cannulation	Transcystic	Retrograde
	Positive (time reduction)	Negative
(6) Flushing of the CBD	Antegrade during basket retrieval (synergic)	Retrograde
	Positive (time reduction)	Not synergic
(7) Papilla manipulation causing oedema or Oddi’s spasm	Limited or absent	Frequent
	Positive (risk reduction)	Negative
(8) Precut of the Papilla	Absent	Possible
	Positive (risk reduction)	Negative
(9) Reduction of the steps of endoscopic procedure	Possible	Uncommon
	Positive (time reduction)	Negative
Total of positive factors	8/9	1/9