Early versus delayed post ercp laparoscopic cholecystectomy

Introduction: The optimal management of symptomatic or suspected common bile duct (CBD) stone continues to be controversial. Preoperative ERCP followed by LC is currently the most widely used procedure. The optimal interval between ERCP and LC is disputed. Aim: The aim of this study was to compare 2 groups of patients managed with laparoscopic cholecystectomy post ERCP after 72 hours and after 4 weeks ) in terms of outcome of LC, the rate of conversion to an open procedure, operative time and hospital stay. Patients and methods: A total of 60 patients divided into two groups of 30 each were included in the study; group one underwent early laparoscopic cholecystectomy whereas group two had delayed laparoscopic cholecystectomy. The length of hospital stay, overall operative time, complications and the rate of conversion to an open procedure in both groups were calculated and statistically analyzed. Results: There were significant differences between both groups as regards morbidity rates, operative time and the mean hospital stay. Conversion to open cholecystectomy occurred in two case due to severe adhesions at the Calot’s triangle in Group II patients. Conclusion: In our study ERCP followed by early laparoscopic cholecystectomy was safe with significant reduction in the average length of stay , operative time , complications and rate of conversion to an open procedure as compared to ERCP followed by delayed laparoscopic cholecystectomy in patients with choledocholithiasis.