MTP5.14 Single-step laparoscopic rendezvous reduces postoperative morbidity in the management of cholecystocholedocholithiasis than ERCP followed by laparoscopic cholecystectomy: a systematic review and meta-analysis

Introduction The objective of this study is to compare the outcomes of patients with cholecystocholedocholithiasis undergoing either single-step laparoscopic rendezvous (LERV) versus the traditional two-step ERCP and laparoscopic cholecystectomy. Methods Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomized controlled trials comparing outcomes of patients with cholecystocholedocholithiasis who were managed surgically with either LERV or ERCP and laparoscopic cholecystectomy. All data were analyzed using Review Manager Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results A total of 7 randomized, control trials were included (n = 1210), recruiting patients who received LERV or two-step ERCP and laparoscopic cholecystectomy. In the random effect model analysis, surgical intervention was shown to reduce length of stay (Standard mean difference (SMD): -1.05, 95% confidence interval (CI): [-1.51, -0.56], Z = 4.41, P < 0.0001). Overall morbidity was also reduced patients undergoing LERV (Odds ratio [OR]: 0.40, 95% CI: [0.26, 0.652], Z = 4.18, P < 0.0001). No significant difference was found in postoperative pancreatitis cases when using LERV (OR: 0.36, 95% CI [0.08, 1.54], Z = 1.38, P = 0.17). Also, no statistical difference was found in successful common bile duct (CBD) stone clearance in either procedure (OR: 1.65, 95% CI [0.71, 3.79], Z = 1.17, P = 0.24). Conclusion LERV was associated with a reduced length of hospital stay and morbidity when compared to two step ERCP and laparoscopic cholecystectomy.