A three-mirror endoscopic technique combining laparoscope, duodenoscope and choledochoscope for treating pancreaticobiliary diseases

Objective To investigate the benefit of treating pancreatic and biliary diseases with a combination of three commonly used minimally invasive endoscopic techniques, including endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction by endoscopic sphincterotomy (EST) , laparoscopic cholecystectomy (LC) , and laparoscopic common bile duct exploration (LCBDE) .Methods A total of 60 patients admitted for treatment of pancreatic and biliary diseases were enrolled in the study.According to indications, 26 patients were treated with ERCP alone, 24 patients were treated with a two endoscope combination (two-mirror I: LC plus duodenoscopy, n=7;two-mirror II: LC plus LCBDE, n=17) , and ten patients were treated with a three endoscope procedure.Intraoperative events and postoperative complications were recorded.Results The ERCP uniscopic procedure had a success rate of 92.6% (2/26 cases were unsuccessful;1/26 required a second stone removal) .Complications were experienced in 15.4% (4/26) of cases, including two cases with a small amount of bleeding in the nipple incision and two cases with hyperamylasemia.All of the operations using the biscopic procedures (two-mirror I and II) and the triscopic procedure were successful, and none of the recipient patients experienced complications.Conclusion Endoscopic (biscopic and triscopic) combination strategies are highly effective and safe for treating pancreatobiliary diseases.