Who experiences endoscopic retrograde cholangiopancreatography after laparoscopic cholecystectomy for symptomatic gallstone disease?
OBJECTIVE
Laparoscopic cholecystectomy (LC) has become a standard treatment of symptomatic gallstone disease. But, some patients suffer from retained common bile duct stones after LC. The aim of this study is to analyze the predicting factors associated with subsequent postoperative endoscopic retrograde cholangiopancreatography (ERCP) after LC.


METHODS
We retrospectively reviewed a database of every LC performed between July 2006 and September 2012. We classify 28 patients who underwent ERCP within 6 months after LC for symptomatic gallstone disease as the ERCP group and 56 patients who underwent LC for symptomatic gallstone disease during same period paired by sex, age, underlying disease, operation history, and body mass index as the control group. To identify risk factor performing postoperative ERCP after LC, we compared admission route, preoperative biochemical liver function test, number of gall stones, gallstone size, adhesion around GB, wall thickening of GB, and existence of acute cholecystitis between the 2 groups.


RESULTS
Admission route, preoperative AST, ALT, and ALP, stone size, longer operation time, and acute cholecystitis were identified as risk factors of postoperative ERCP in univariate analyses. But, longer operation time (P = 0.004) and acute cholecystitis (P = 0.048) were identified as independent risk factors of postoperative ERCP in multivariate analyses.


CONCLUSIONS
The patient who underwent ERCP after LC for symptomatic gallstone disease are more likely experienced longer operation time and acute cholecystitis than the patient who did not undergo ERCP after LC.
Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.
Bum-Soo
BS
Kim
Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.
Sun-Hyung
SH
Joo
Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.
Sungsin
S
Cho
Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.
Min-Soo
MS
Han
Common bile duct stones; Endoscopic retrograde cholangiopancreatography; Laparoscopic cholecystectomy