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Laparoscopic cholecystectomy after endoscopic treatment of choledocholithiasis: a retrospective comparative study

  • Mario Trejo-Ávila
  • Danilo Solórzano-Vicuña
  • Ricardo García-Corral
  • Orlando Bada-Yllán
  • Adolfo Cuendis-Velázquez
  • Roberto Delano-Alonso
  • Jesus Herrera-Esquivel
  • Carlos Valenzuela-Salazar
Original Article
  • 2 Downloads

Abstract

Patients with combined choledocholithiasis and cholecystitis require treatment of both diseases. The aim of our study was to analyze perioperative results of next-day (< 24 h) vs. early (> 24 h) laparoscopic cholecystectomy (LC) after endoscopic clearance of common bile duct stones. We conducted a retrospective study of patients that underwent LC after endoscopic treatment of choledocholithiasis, with combined diagnoses of common bile duct stones (with or without acute cholangitis) and gallbladder stones (with acute or chronic cholecystitis). From January 2014 to May 2017, 87 patients underwent LC after endoscopic sphincterotomy: 40 patients within 24 h (NDLC) and 47 after 24 h (ELC). Regarding pre-ERCP diagnosis, 29 (72.5%) of patients in the NDLC group and 33 (70.2%) of patients in the ELC group had high-risk of choledocholithiasis (p = 0.814), acute cholecystitis (32.5 vs. 25.5%, p = 0.474) and acute cholangitis (17.5 vs. 17%, p = 0.953). The median time from ERCP to LC was 23 h (IQR 22–23) in the NDLC group and 72 h (IQR 48–80) in the ELC group (p < 0.001). No statistically significant differences were found in regard to operative time, estimated blood loss, overall morbidity and rate of conversion to open surgery. Patients in the NDLC group had a shorter total length of stay (2 vs. 4 days, p < 0.001). Laparoscopic cholecystectomy performed within the first 24 h after endoscopic treatment of choledocholithiasis is safe and feasible, without increased postoperative morbidity and associated with reduction of the hospital length of stay.

Keywords

Laparoscopic cholecystectomy ERCP Choledocholithiasis Endoscopic sphincterotomy 

Notes

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

No informed consent was required due to the retrospective nature of the study.

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Copyright information

© Italian Society of Surgery (SIC) 2019

Authors and Affiliations

  • Mario Trejo-Ávila
    • 1
  • Danilo Solórzano-Vicuña
    • 1
  • Ricardo García-Corral
    • 1
  • Orlando Bada-Yllán
    • 1
  • Adolfo Cuendis-Velázquez
    • 1
  • Roberto Delano-Alonso
    • 1
  • Jesus Herrera-Esquivel
    • 1
  • Carlos Valenzuela-Salazar
    • 1
  1. 1.Department of General and Endoscopic SurgeryHospital General Dr. Manuel Gea GonzálezMexico CityMexico

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