The timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreaticography in cholelithiasis coexisting with choledocholithiasis.
BACKGROUND
An accepted treatment strategy for cholelithiasis with secondary choledocholithiasis is the laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreaticography (ERCP). Although early cholecystectomy is advised, there is no consensus about the time interval between LC and ERCP. The aim of this study is to evaluate the effects of the time interval between ERCP and ERCP on operation outcomes.


METHODS
Patients with cholelithiasis and a risk of choledocholithiasis underwent ERCP. Patients were grouped as those operated on between 24 and 72 h after ERCP (group 1) and those operated on more than 72 h after ERCP (group 2). Patients' age, gender, body mass index, American Society of Anesthesiologists Physical Status, abdominal ultrasonography findings, white blood cell count, total serum bilirubin, ALP, amylase, ALT, AST, GGT levels, ERCP findings, time interval between ERCP and LC, conversion rate, median postoperative hospital stay, median operation time, intraoperative complication and postoperative complication rates were collected.


RESULTS
There was no significant difference between the demographics of the patients in both groups. The median operation time, median postoperative hospital stay and conversion rate in group 2 were significantly higher than those of group 1. More postoperative complications were seen in group 2.


CONCLUSIONS
Early cholecystectomy after ERCP, within 72 h, has better outcomes, probably due to the inflammatory processes.
Salman
Bulent
B
Department of General Surgery, Gazi University Medical School, Beşevler, 06500, Ankara, Turkey. bsalman@gazi.edu.tr
Yilmaz
Utku
U
Kerem
Mustafa
M
Bedirli
Abdulkadir
A
Sare
Mustafa
M
Sakrak
Omer
O
Tatlicioglu
Ertan
E
D000328:Adult; D016009:Chi-Square Distribution; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D042883:Choledocholithiasis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002769:Cholelithiasis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors