Journal: |
CLINICAL IN SURGERY
Wolters Kluwer
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Abstract: |
Purpose
To establish the feasibility, complications, and outcome of different time intervals
between endoscopic retrograde cholangiopancreatography (ERCP) and
laparoscopic cholecystectomy (LC) in the management of choledocholithiasis.
Patients and methods
This study was carried out on 60 patients who were randomized by systematic
randomization into three equal groups according to the interval between ERCP and
LC defined as short (3 days or less), medium (4–60 days), or long (60 days or more).
All patients have undergone ERCP with sphincterotomy followed by elective LC.
Patients’ age, sex, history of previous acute cholecystitis, acute pancreatitis and
jaundice, abdominal ultrasonography findings, serum bilirubin, alkaline
phosphatase, gamma-glutamyl transferase levels, ERCP findings, time interval
between ERCP and LC, conversion rate, median operative time, intraoperative
complications, hospital stay, and postoperative complication rates were collected.
Results
There was no statistically significant difference between the demographics of the
patients, the preoperative history, laboratory data or ultrasonographic findings in
the three groups. The density of encountered adhesions intraoperatively, median
operation time, and median postoperative hospital stay in groups 2 and 3 were
significantly higher than those of group 1. Other intraoperative and postoperative
complications or conversion showed no statistically significant difference.
Conclusion
Early cholecystectomy after ERCP within 72 h has better outcomes, probably due to
less inflammatory processes following ERCP than in groups II and III.
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