RESUMO L’articolo si propone di analizzare il dibattito che ha caratterizzato l’XI secolo alla luce dell’onnipotenza divina, con particolare riguardo per le riflessioni di Pier Damiani e Anselmo d’Aosta. Dopo aver presentato la disputa tra Lanfranco di Pavia e Berengario di Tours sul ruolo e la funzione dell’ars dialectica, l’articolo si concentra sul De divina omnipotentia di Damiani, mettendo in risalto la radicalità dell’approccio sostenuto dal monaco ravennate. L’articolo procede prendendo in esame la posizione sostenuta da Anselmo nel Proslogion, nel De libertate arbitrii, nel De casu diaboli e nel Cur Deus homo per porre in risalto la centralità dell’approccio anselmiano nella storia successiva della filosofia medievale.

ABSTRACT The article aims to analyse the debate that characterized the Eleventh Century in the light of divine omnipotence, with particular regard to the speculations of Peter Damian and Anselm of Aosta. After presenting the dispute between Lanfranc of Pavia and Berengar of Tours about the role and the function of the ars dialectica, the article focuses on Damian’s De divina omnipotentia, underling the radicalism of the approach defended by the Italian monk. The article proceeds by analysing the position supported by Anselm in the Proslogion, in the De libertate arbitrii, in the De casu diaboli and in the Cur Deus homo, with the aim of highlighting the centrality of Anselm’s approach in the later history of Medieval philosophy.

Endoscopic retrograde cholangiopancreatography (ERCP) is the treatment of choice in patients with choledocholithiasis. However, despite its high success rate, in some cases it is not successful, requiring alternative therapy. Billroth II partial gastrectomy is a condition associated with an important failure rate of ERCP. When endoscopic treatment fails, surgical exploration of the bile duct is the most common approach. However, the surgery is related to a greater complexity of execution and morbimortality. We describe the case of a patient with choledocholithiasis and Billroth II partial gastrectomy, submitted to the combined treatment called rendez-vous laparoendoscopic, after failure of ERCP, which unites in a single stage the endoscopic treatment of choledocholithiasis and laparoscopic removal of the gallbladder. We conclude that this therapeutic approach was effective, safe, with low cost and without complications.

La colangiopancreatografía endoscópica retrógrada (CPRE) es el tratamiento de elección en pacientes portadores de coledocolitiasis. Sin embargo, a pesar de su elevada tasa de éxito, en algunos casos no es exitosa, exigiendo terapia alternativa. La gastrectomía parcial con reconstrucción a Billroth II es una condición asociada a la importante tasa de fracaso de la CPRE. Cuando el tratamiento endoscópico falla, la exploración quirúrgica de la vía biliar es un enfoque más común. Sin embargo, la cirugía se relaciona con una mayor complejidad de ejecución y morbimortalidad. Describimos el caso de un paciente con coledocolitiasis y gastrectomía parcial con reconstrucción a Billroth II, sometido al tratamiento combinado denominado rendez-vous laparoendoscópico tras fallo de la CPRE, que une en una sola etapa el tratamiento endoscópico de la coledocolitiasis y la retirada laparoscópica de la vesícula biliar. Llegamos a la conclusión de que este enfoque terapéutico fue eficaz, seguro, de bajo costo y sin complicaciones.