Single-Stage Laparoscopic-Endoscopic Rendezvous Technique for Choledocholithiasis: Clinical Outcomes From 1008 Consecutive Patients

Background: Two-stage management of choledocholithiasis may be associated with procedure-related complications, repeated interventions, and longer hospital stays. While single-stage laparoscopic common bile duct exploration avoids these risks, it requires advanced laparoscopic expertise. We evaluated the outcomes of the single-stage laparoscopic-endoscopic rendezvous (LER) technique in a large, consecutive cohort. Methods: A STROBE-compliant retrospective analysis was conducted on 1,008 consecutive adult patients with symptomatic cholelithiasis and magnetic resonance cholangiopancreatography-confirmed common bile duct stones (≤15 mm) between 2016 and 2024. The primary outcome was procedural success (complete clearance without conversion). Secondary outcomes included 30-day morbidity and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) incidence. Results: Procedural success was achieved in 927 patients (92.0%). The mean operative time was 52.4 ± 12.7 minutes. The overall 30-day minor complication rate was 1.9%, with no observed cases of PEP (0%; 95% CI 0-0.4%). Stone number >3 was the sole independent predictor of failure (OR 4.21; p < 0.001). Conclusion: Single-stage LER is a safe, efficient, and reproducible technique that eliminates PEP and provides high ductal clearance.