Immediate versus Delayed Laparoscopic Cholecystectomy after Endoscopic Retrograde Cholangiopancreatography in Choledocholithiasis

Document Type : Original Article

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Abstract

Background: There would be less need for emergency open cholecystectomy and fewer problems if cholecystectomy was performed soon following endoscopic retrograde cholangiopancreatography (ERCP).
Objective: This study aimed to evaluate the advantages of immediate over delayed laparoscopic cholecystectomy among patients who had common bile duct stones post ERCP regarding outcome, safety and complications.
Subjects and Methods: At General Surgery Department of Zagazig University Hospitals, 60 patients with cholecystolithiasis after doing ERCP were divided into 2 groups. Group (A) for immediate laparoscopic cholecystectomy (LC) in same sitting after ERCP and Group (B) for delayed LC (4 weeks or more) after ERCP. Conversion rate, operative time, intra- and post-operative complications were assessed.
Results: The mean operative time was shorter in the immediate group (54.96 ± 14.21 min.) than in the delayed group (71.66 ± 24.72 min.), which represented a significant difference in favor of the immediate group. There was a statistically significant distinction in the incidence of complications after surgery where in delayed group five patients showed intraoperative bleeding and three patients converted to open cholecystectomy. Length of hospital stays also differed significantly between groups, 0.9 versus 1.95 for immediate LC group & delayed LC group, respectively.
Conclusion: Performing immediate LC post, ERCP in comparison to delayed LC after ERCP had better outcomes. It had the lower conversion rate, less operative time, shorter hospital stay, and less intra-operative and post-operative complications.
 

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The Egyptian Journal of Hospital Medicine
Volume 89, Issue 1
October 2022
Pages 4685-4691

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