Comparative analysis of surgical outcomes: post-ERCP laparoscopic cholecystectomy versus elective laparoscopic cholecystectomy

Abstract

Aims: Gallstones are widespread in the adult population. In some patients, the stones are not confined to the gallbladder but are also found in the biliary tract. Although the treatment approach for this group of patients is controversial, the most widely accepted treatment is laparoscopic cholecystectomy (LC) after removal of the stones by endoscopic retrograde cholangiopancreaticography (ERCP). Opinions differ as to whether LC should be performed early or late. With this study, we wanted to shed light on this question based on our own clinical experience. Methods: A total of 100 patients who underwent LC in our clinic were included in the study. These patients were divided into two groups: 50 patients who underwent ERCP and early cholecystectomy (group 1) and 50 patients who underwent elective LC for gallstones (group 2). Patients who underwent ERCP for malignant or benign stricture, patients with porcelain sac, patients with previous abdominal surgery, patients who underwent emergency LC, patients younger than 18 years old, and patients with incomplete data, incomplete records, or patients whose necessary information could not be accessed were excluded. Results: There was no statistically significant difference between age and preoperative amylase levels. The mean length of hospital stay was 3.9±1.6 days in patients who underwent elective LC and 5.5±3.2 days in patients who underwent LC after ERCP. There was a statistically significant difference between postoperative amylase level, hemoglobin level and length of hospital stay (p<0.05). Postoperative amylase levels and length of hospital stay were higher in group 1. There was a significant difference between the groups in terms of surgical procedure (p<0.05). In group 1, laparoscopic cholecystectomy (LC) was performed in 76% of patients, while in group 2, LC was performed in 94% of patients. It was found that the rate of conversion to patency was higher in group 1. There was no statistically significant difference between the groups in terms of postoperative and preoperative complications Conclusion: In conclusion, our study highlights early cholecystectomy after ERCP to reduce potential complications in the treatment of gallstones, while emphasising the need for close patient follow-up and further research validation.