Optimal timing of laparoscopic cholecystectomy post-endoscopic retrograde cholangiography and common bile duct clearance: A prospective observational study
Background: The treatment of patients with cholelithiasis with common bile duct (CBD) stones is CBD clearance with cholecystectomy. While traditional teachings advocate waiting for 4–6-week post-endoscopic retrograde cholangiography (ERCP) with CBD clearance, recent studies favour an early laparosco...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Journal of Minimal Access Surgery |
| Subjects: | |
| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2022;volume=18;issue=3;spage=438;epage=442;aulast=Prajapati |
| _version_ | 1811217835270078464 |
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| author | Ramlal P Prajapati Sidhant R Vairagar Amay M Banker Monty U Khajanchi |
| author_facet | Ramlal P Prajapati Sidhant R Vairagar Amay M Banker Monty U Khajanchi |
| author_sort | Ramlal P Prajapati |
| collection | DOAJ |
| description | Background: The treatment of patients with cholelithiasis with common bile duct (CBD) stones is CBD clearance with cholecystectomy. While traditional teachings advocate waiting for 4–6-week post-endoscopic retrograde cholangiography (ERCP) with CBD clearance, recent studies favour an early laparoscopic cholecystectomy (LC). Hence, this study was conducted to evaluate the optimal timing of LC post-ERCP.
Methods: We conducted a prospective observational study between March 2017 and October 2018. Patients diagnosed with cholelithiasis and CBS stones on ultrasonography or computed tomography were included. They were assigned to one of two groups (<2 weeks and >2 weeks) based on the time interval between ERCP and subsequent LC. Chi-square test was used to analyse the intraoperative and post-operative outcomes between the two study groups,
Results: One hundred and forty patients were included in the study of which 69 underwent an early LC (<2 weeks). There was a significant decrease in the blood loss and incidence of bowel injury in the early group. Calots triangle was better defined and critical view of safety was achieved more in the patients who underwent an early LC. This resulted in a significantly lower incidence of drain placement and length of hospital stay in those patients who underwent an early LC.
Conclusion: A delay of 2 weeks after ERCP makes the LC more difficult and is associated with a longer hospital stay. We advocate LC within 2 weeks of ERCP whenever feasible. |
| first_indexed | 2024-04-12T07:00:47Z |
| format | Article |
| id | doaj.art-cbc54c684edb488fb662bc379c5d1c91 |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-04-12T07:00:47Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-cbc54c684edb488fb662bc379c5d1c912022-12-22T03:43:01ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212022-01-0118343844210.4103/jmas.jmas_321_21Optimal timing of laparoscopic cholecystectomy post-endoscopic retrograde cholangiography and common bile duct clearance: A prospective observational studyRamlal P PrajapatiSidhant R VairagarAmay M BankerMonty U KhajanchiBackground: The treatment of patients with cholelithiasis with common bile duct (CBD) stones is CBD clearance with cholecystectomy. While traditional teachings advocate waiting for 4–6-week post-endoscopic retrograde cholangiography (ERCP) with CBD clearance, recent studies favour an early laparoscopic cholecystectomy (LC). Hence, this study was conducted to evaluate the optimal timing of LC post-ERCP. Methods: We conducted a prospective observational study between March 2017 and October 2018. Patients diagnosed with cholelithiasis and CBS stones on ultrasonography or computed tomography were included. They were assigned to one of two groups (<2 weeks and >2 weeks) based on the time interval between ERCP and subsequent LC. Chi-square test was used to analyse the intraoperative and post-operative outcomes between the two study groups, Results: One hundred and forty patients were included in the study of which 69 underwent an early LC (<2 weeks). There was a significant decrease in the blood loss and incidence of bowel injury in the early group. Calots triangle was better defined and critical view of safety was achieved more in the patients who underwent an early LC. This resulted in a significantly lower incidence of drain placement and length of hospital stay in those patients who underwent an early LC. Conclusion: A delay of 2 weeks after ERCP makes the LC more difficult and is associated with a longer hospital stay. We advocate LC within 2 weeks of ERCP whenever feasible.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2022;volume=18;issue=3;spage=438;epage=442;aulast=Prajapaticommon bile duct clearanceendoscopic retrograde cholangiographylaparoscopic cholecystectomy |
| spellingShingle | Ramlal P Prajapati Sidhant R Vairagar Amay M Banker Monty U Khajanchi Optimal timing of laparoscopic cholecystectomy post-endoscopic retrograde cholangiography and common bile duct clearance: A prospective observational study Journal of Minimal Access Surgery common bile duct clearance endoscopic retrograde cholangiography laparoscopic cholecystectomy |
| title | Optimal timing of laparoscopic cholecystectomy post-endoscopic retrograde cholangiography and common bile duct clearance: A prospective observational study |
| title_full | Optimal timing of laparoscopic cholecystectomy post-endoscopic retrograde cholangiography and common bile duct clearance: A prospective observational study |
| title_fullStr | Optimal timing of laparoscopic cholecystectomy post-endoscopic retrograde cholangiography and common bile duct clearance: A prospective observational study |
| title_full_unstemmed | Optimal timing of laparoscopic cholecystectomy post-endoscopic retrograde cholangiography and common bile duct clearance: A prospective observational study |
| title_short | Optimal timing of laparoscopic cholecystectomy post-endoscopic retrograde cholangiography and common bile duct clearance: A prospective observational study |
| title_sort | optimal timing of laparoscopic cholecystectomy post endoscopic retrograde cholangiography and common bile duct clearance a prospective observational study |
| topic | common bile duct clearance endoscopic retrograde cholangiography laparoscopic cholecystectomy |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2022;volume=18;issue=3;spage=438;epage=442;aulast=Prajapati |
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