The suitable time of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in gallstone-disease-associated choledocholithiasis

Abstract

Purpose To establish the feasibility, complications, and outcome of different time intervals between endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC) in the management of choledocholithiasis. Patients and methods This study was carried out on 60 patients who were randomized by systematic randomization into three equal groups according to the interval between ERCP and LC defined as short (3 days or less), medium (4–60 days), or long (60 days or more). All patients have undergone ERCP with sphincterotomy followed by elective LC. Patients’ age, sex, history of previous acute cholecystitis, acute pancreatitis and jaundice, abdominal ultrasonography findings, serum bilirubin, alkaline phosphatase, gamma-glutamyl transferase levels, ERCP findings, time interval between ERCP and LC, conversion rate, median operative time, intraoperative complications, hospital stay, and postoperative complication rates were collected. Results There was no statistically significant difference between the demographics of the patients, the preoperative history, laboratory data or ultrasonographic findings in the three groups. The density of encountered adhesions intraoperatively, median operation time, and median postoperative hospital stay in groups 2 and 3 were significantly higher than those of group 1. Other intraoperative and postoperative complications or conversion showed no statistically significant difference. Conclusion Early cholecystectomy after ERCP within 72 h has better outcomes, probably due to less inflammatory processes following ERCP than in groups II and III.