A comparative study on early versus late laparoscopic cholecystectomy in a post ERCP patient with cholelithiasis with choledocholithiasis: a single institutional study in a tertiary centre in Nepal

Background: An accepted surgical modality for cholelithiasis with secondary choledocholithiasis is the laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreatography (ERCP). Despite recommendation for early cholecystectomy, there is no consensus about the time interval between LC and ERCP. The study aims to compare Early (<72 hours) versus Late (>6 weeks) laparoscopic cholecystectomy in post-ERCP patient with cholelithiasis with choledocholithiasis in terms of intra operative and post operative complications. Methods: 58 patients who underwent ERCP were followed up in two groups with 29 patients each for those who had early (<72 hours) laparoscopic cholecystectomy (LC) (Group 1) and late (>6 weeks) LC (Group 2) and compared for intraoperative and post operative complications. Patients’ age, gender, abdominal ultrasonography findings, ERCP findings, time interval between ERCP and LC, conversion rate, length of hospital stay, operation time, intraoperative complication and postoperative complication rates were collected. Results: The mean±SD age of the study participants in this study was 45.5±15.8 years. No patients underwent conversion to open cholecystectomy. Operative time were similar in both groups (p=0.941). There was no statistically significant difference in difficult in Calot’s dissection and time to achieve critical view of safety. No biliary tract injury was reported while requirement for blood transfusion (p=0.490) and drain placement (p=0.610) were similar in both groups. Conclusions: The intra operative and post operative outcome with early (<72 hours) and late (>6 weeks) laparoscopic cholecystitis post ERCP in patients with cholelithiasis and choledocholithiasis is similar.