Comparative Analysis of Early versus Late Laparoscopic Cholecystectomy Following Endoscopic Retrograde Cholangiopancreaticography in Cases of Cholelithiasis with Choledocholithiasis

Abstract

A bstract Introduction A preferred treatment for cholelithiasis with choledocholithiasis is endoscopic retrograde cholangiopancreaticography (ERCP) followed by laparoscopic cholecystectomy (LC), which can be performed early (within 72 hours) or can be delayed for 6 to 8 weeks. This study is conducted to compare and analyze the outcome of early versus late LC following common bile duct (CBD) clearance by ERCP and determine the optimum timing for performing LC post-ERCP. Materials and methods This comparative analysis was conducted at St Joseph Hospital, Ghaziabad, from September 2019 to March 2021 on 89 cases of cholelithiasis with choledocholithiasis. Patients were divided into two groups. Group I ( n = 45) patients underwent early LC within 72 hours post-ERCP and group II ( n = 44) patients underwent late LC after an interval of 8 weeks. Various preoperative, perioperative, and postoperative clinical parameters like operative difficulty, complications, surgery duration, hospital stay, and conversion to open cholecystectomy were analyzed. Results There was no significant difference in demographic and laboratory findings in both groups. Group I patients had significantly shorter hospital stay and less operative difficulty. The duration of surgery was significantly low in group I. There was no significant difference in rate of conversion to open cholecystectomy. Conclusion Early LC post-ERCP is associated with short hospital stay and duration of surgery and less operative difficulty and complications. Therefore, we recommend that LC can be safely performed within 48 to 72 hours after ERCP. How to cite this article Goel A, Kothari S, Bansal R. Comparative Analysis of Early versus Late Laparoscopic Cholecystectomy Following Endoscopic Retrograde Cholangiopancreaticography in Cases of Cholelithiasis with Choledocholithiasis. Euroasian J Hepato-Gastroenterol 2021;11(1):11–13.

Effect of Endoscopic Retrograde Cholangiopancreatography Lithotomy Combined with Laparoscopic Cholecystectomy on Pain and Prognosis of Patients with Gallstones and Extrahepatic Bile Duct Stones

“…At the same time, it also effectively expands the application range of minimally invasive surgery in biliary surgery, without T tube drainage, which not only ensures the normal physiological function of the digestive tract and biliary integrity but also reduces the pain of patients. In addition, ERCP + lithotomy combined with LC, as a minimally invasive surgery, has little trauma, can effectively reduce unnecessary injuries, and avoid water, electrolyte, and physiological dysfunction caused by bile outflow, which is beneficial to relieve patients' pain [ 19 , 20 ].…”

Meta-analysis of the timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in patients with cholecystolithiasis and choledocholithiasis

“…1. There were six randomized controlled trials [11][12][13][14][15][16] and six non-randomized observational clinical studies [17][18][19][20][21][22]. The basic characteristics and patient conditions of the 12 literatures included were shown in Table 1, and then the selected literatures were evaluated.…”

“…All studies [11][12][13][14][15][16][17][18][19][20][21][22] compared the complications of cholecystectomy between the two groups, involving a total of 1142 patients, including incision infection, fever, bleeding, biliary tract injury, bile leakage, hyperamylasemia, pancreatitis, reflux cholangitis, atelectasis, etc. The important complications of these literatures are shown in Table 3.…”

“…Eight studies [12,[14][15][16][17][18][19][20] compared the data related to conversion to open cholecystectomy between the two groups, with a total of 804 patients. The results showed good heterogeneity (I 2 = 0%), and the fixed-effect model was used for analysis.…”

Laparoscopic Cholecystectomy within 24 Hours Following Endoscopic Retrograde Cholangiography as a Good Option for the Treatment of Cholecysto-Choledocholithiasis

“…This included endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC), LC with intraoperative ERCP, laparoscopic common bile duct exploration, and open common bile duct exploration. Among those treatment options, ERCP followed by LC appears to be the safest and the least invasive [3,4] . Manes et al mentioned that there is a 4% to 24% risk of biliary complications following ERCP if the LC is not performed early after the surgery.…”