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

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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.

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

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Authors and Affiliations

  1. Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, Mexico City, 14090, Mexico

    Mario Trejo-Ávila, Danilo Solórzano-Vicuña, Ricardo García-Corral, Orlando Bada-Yllán, Adolfo Cuendis-Velázquez, Roberto Delano-Alonso, Jesus Herrera-Esquivel & Carlos Valenzuela-Salazar

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  1. Mario Trejo-Ávila
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  2. Danilo Solórzano-Vicuña
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  3. Ricardo García-Corral
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  4. Orlando Bada-Yllán
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  5. Adolfo Cuendis-Velázquez
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  6. Roberto Delano-Alonso
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  7. Jesus Herrera-Esquivel
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  8. Carlos Valenzuela-Salazar
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Correspondence to Mario Trejo-Ávila.

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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.

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Trejo-Ávila, M., Solórzano-Vicuña, D., García-Corral, R. et al. Laparoscopic cholecystectomy after endoscopic treatment of choledocholithiasis: a retrospective comparative study. Updates Surg 71, 669–675 (2019). https://doi.org/10.1007/s13304-019-00624-5

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