A comparative study of post ERCP early versus late laparoscopic cholecystectomy in cases of choledochocystolithiasis

Rajesh K. Patel; Ravi P. Gadani; Rakesh A. Makwana

Volume : VIII, Issue : XII, December - 2019

A comparative study of post ERCP early versus late laparoscopic cholecystectomy in cases of choledochocystolithiasis

Rajesh K. Patel, Ravi P. Gadani, Rakesh A. Makwana

Abstract :

The current standard treatment for choledochocystolithiasis is endoscopic removal of stone followed by laparoscopic cholectstectomy. In the present study we compare early versus delayed laparoscopic cholecystectomy (ELC vs DLC) after Endoscopic Retrograde Cholangiopancreatography (ERCP) in cases of choledochocystolithiasis. A total 40 patients, who underwent Laparoscopic Cholecystectomy (LC) after ERCP for choledochocystolithiasis. ELC was defined as LC within 72 hrs of ERCP and DLC was defined as LC after 72 hrs upto 28 days of ERCP. Out of 40 total patients 20 patients were allocated to each group. In both groups intra operative findings and difficulty, duration of surgery, hospital stay and postoperative complication were noted and compared. Occurrence of peri gall bladder adhesions were more in DLC group as compared with ELC group. Which were statistically significant. Conversion to open cholecystectomy occur in 3 patients in DLC group and in 1 patient in group ELC. Mean duration of surgery was 78.8� 13.63 min in group ELC and was 87.25� 15.68 in group DLC. These differences in observations were also statistically significant. The mean Post –operative hospital stay in our study in Group ELC were 3 days and in Group DLC it was 5.7 days and it was also significant at p<0.01 level. The postoperative complication rates were 10%(2/20) in Group ELC and 30%(6/20) in Group DLC 4 patients have wound infection. In group ELC only 2 patients have wound infection. Intra– abdominal collection were noted in 1 patient in group DLC. No mortality was noted in any group.