Optimal Timing of Laparoscopic Cholecystectomy After Endoscopic Retrograde Cholangiopancreatography

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) comprises the current treatment modality in patients with common bile duct (CBD) stones. The optimum interval between ERCP and LC is a topic of debate. Methods: A total of 50 patients underwent LC following ERCP from December 2011 to October 2013. Of these, 28 patients under- went surgery within 3 days of ERCP (early) and 22 patients beyond 3 days following ERCP (delayed). A prospective observational study of various technical difficulties encountered (operative dura- tion, adhesions, frozen Calot’s, bile duct injuries, conversion rate and need for drain) was done and comparison was done. Results: The incidence of adhesions, frozen Calot’s, cystic duct in- jury, need for drain placement and the mean operative duration and postoperative stay were significantly higher in the delayed group. The conversion rate though higher is not statistically significant. Conclusion: The longer the interval between ERCP and LC, the higher are the chances of encountering complications and the risk of conversion to open technique as well as the need for increased hospital stay following surgery. Early LC following ERCP is pre- ferred.