Optimal Timing for Laparoscopic Cholecystectomy After Endoscopic Retrograde Cholangiopancreatography: A Systematic Review

2017 ◽  
Vol 107 (2) ◽  
pp. 99-106 ◽  
Author(s):  
C. Friis ◽  
J. P. Rothman ◽  
J. Burcharth ◽  
J. Rosenberg
Keyword(s):  
Systematic Review ◽  
Laparoscopic Cholecystectomy ◽  
Length Of Stay ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Conversion Rate ◽  
Operating Time ◽  
Definitive Treatment ◽  
Optimal Time ◽  
Time Interval ◽  
Endoscopic Retrograde

Background and Aims: Endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy is often used as definitive treatment for common bile duct stones. The aim of this study was to investigate the optimal time interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. Materials and Methods: PubMed and Embase were searched for studies comparing different time delays between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. Observational studies and randomized controlled trials were included. Primary outcome was conversion rate from laparoscopic to open cholecystectomy and secondary outcomes were complications, mortality, operating time, and length of stay. Results: A total of 14 studies with a total of 1930 patients were included. The pooled estimate revealed an increase from a 4.2% conversion rate when laparoscopic cholecystectomy was performed within 24 h of endoscopic retrograde cholangiopancreatography to 7.6% for 24–72 h delay to 12.3% when performed within 2 weeks, to 12.3% for 2–6 weeks, and to a 14% conversion rate when operation was delayed more than 6 weeks. Conclusion: According to this systematic review, it is preferable to perform cholecystectomy within 24 h of endoscopic retrograde cholangiopancreatography to reduce conversion rate. Early laparoscopic cholecystectomy does not increase mortality, perioperative complications, or length of stay and on the contrary it reduces the risk of reoccurrence and progression of disease in the delay between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy.

scholarly journals Factors Associated with the Success Rate of Endoscopic Retrograde Cholangiopancreatography with Standard Technique followed by Laparoscopic Cholecystectomy in the Management of Choledocholithiasis: A Single-Center Experience

2020 ◽  
Vol 11 (02) ◽  
pp. 126-133
Author(s):  
Chayanon Konsue ◽  
Chalerm Eurboonyanun ◽  
Somchai Ruangwannasak ◽  
Kulyada Eurboonyanun ◽  
Tharatip Srisuk ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Success Rate ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Conversion Rate ◽  
Standard Technique ◽  
Endoscopic Retrograde ◽  
Biliary Clearance ◽  
Factors Associated

Abstract Background Choledocholithiasis is the most common benign biliary disease. Endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) has been the first-line therapy in recent years, although laparoscopic common bile duct exploration has promising results. This retrospective study aimed to define the factors associated with biliary clearance by standard ERCP technique and conversion rate of LC. Materials and Methods We retrospectively evaluated the records of 217 choledocholithiasis patients who had undergone ERCP with stone removal by the standard technique from 2010 to 2018. A failed ERCP was defined when the first ERCP session could not remove the stones . The number of patients who later underwent open cholecystectomy or LC was also recorded. Conversion was defined when LC had to be converted OC. Statistical Analysis Student’s t-test was used for the comparison of continuous variables. Nominal variables were analyzed using Pearson’s chi-square test or Fisher’s exact test. Binary logistic regression was performed for multivariate analysis. Results The rate of successful biliary clearance was 81.1%. Of the patients, 109 (50.2%) had difficult stones. Increasing age (p = 0.004), increasing number (p = 0.001), and increasing size of stone (p < 0.001) were the three significant factors that were associated with the failure of biliary clearance. The difficult stone group had a higher failure rate of ERCP and a higher conversion rate of LC compared with the easy stone group (p = 0.001 and p = 0.027, respectively). Conclusions ERCP with the standard technique is a highly effective and safe management option for patients with common bile duct (CBD) stones. The difficult stone group was found to be an independent risk factor that affected the success rate of both ERCP and the following LC. Difficult stone criteria should be assessed to identify a patient who might benefit from laparoscopic CBD exploration.

Laparoscopic Cholecystectomy after Endoscopic Retrograde Cholangiopancreatography

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Prof. Dr./Abd El Ghany Mahmoud El Shamy ◽  
Dr./Ahmed Magdy Ahmed Farrag ◽  
Ahmed Kamal Mohammed Mohammed
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Conversion Rate ◽  
Endoscopic Sphincterotomy ◽  
Endoscopic Retrograde ◽  
Critical View Of Safety ◽  
Experienced Surgeon ◽  
Group 12 ◽  
High Conversion Rate ◽  
Duration Of Operation

Abstract Background Laparoscopic cholecystectomy (LC) post Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy(ES) is generally accepted as the treatment of choice for patient with choledococystolithiasis. Previous studies have shown that LC after ERCP is associated with a high conversion rate. The aim of the present study was to assess the complexity of LC after ERCP compared with standard LC for symptomatic uncomplicated cholecystolithiasis. Objective s: So the aim of this study is to assess the complexity of LC post ERCP comparted to elective LC without previous ERCP. Method The study is a prospective cohort study of two groups of patients: patients who had undergone a previous ERCP for choledocolithiasis (PES) and patients with cholecystolithiasis who had no previous intervention prior to LC (NPES). Results The PES group consists of 25 patients and the NPES group consists of 25 consecutive patients, patients in the PES group had a higher risks for longer (more than 35 min) duration of operation, the conversion rate in the PES group and the NPES group (12% versus 0%, respectively) were not significantly different, duration of post-operative hospital stay in the PES group was longer than NPES group, there was more difficulty in achieving the critical view of safety in the PES group (easily achieved in 48%) than NPES group(easily achieved in 92%). Conclusion A laparoscopic cholecystectomy after ES is longer and more difficult than in uncomplicated cholelithiasis and should therefore be performed by an experienced surgeon.

scholarly journals Results of combiation of laparoscopic cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (ERCP) simultaneously

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Đức Hùng Mai ◽  
Văn Nghĩa Nguyễn
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
General Anesthesia ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Operating Time ◽  
Endoscopic Retrograde ◽  
Cross Sectional ◽  
Biliary Lithiasis ◽  
Operative Complications ◽  
The Mean

Tóm tắt Đặt vấn đề: Đánh giá kết quả phẫu thuật nội soi cắt túi mật kết hợp nội soi mật tụy ngược dòng điều trị sỏi đường mật đồng thời trong cùng một thì gây mê. Phương pháp nghiên cứu: Nghiên cứu hồi cứu, mô tả cắt ngang với 88 bệnh nhân có sỏi túi mật và sỏi đường mật được phẫu thuật nội soi (PTNS) cắt túi mật kết hợp nội soi mật tụy ngược dòng (NSMTND) điều trị sỏi đường mật đồng thời từ 1/2015 đến 11/2017 tại Bệnh viện Nhân dân 115. Kết quả: Tuổi trung bình là 59,8 ± 15,0; tỉ lệ nữ 59,1%; tỉ lệ có bệnh mạn tính kèm theo 40,9%. Thời gian PTNS cắt túi mật và NSMTND lấy sỏi 123,1 ± 33,4 phút. Tỉ lệ thành công 93,2%, sạch sỏi 87,8%. Tai biến phẫu thuật 0%, biến chứng sớm 12,4%, tử vong 0%. Thời gian nằm viện sau phẫu thuật trung bình 4,2 ± 2,8 (2 – 20 ngày). Kết quả ra viện tốt 78,4%, khá 14,8%, trung bình 6,8%. Kết luận: Kết quả phẫu thuật nội soi cắt túi mật và nội soi mật tụy ngược dòng điều trị sỏi đường mật đồng thời là khả thi và an toàn. Abstract Introduction: To evaluate the results of the gallbadder and bile duct gallstone patients were treated with laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography ERCP in removing the stones when the patients were undergoing the same general anesthesia. Material and Methods: Cross-sectional retrospective study was conducted on 88 patients treated with laparoscopic cholecystectomy and ERCP to remove the stones under the same general anesthesia from January 2015 to November 2017 at the 115 Peoples Hospital. Results: The mean age of patients was 59.8 ± 15 years; the female was 59.1%; there were 40.9% of the patients with comorbidities. The mean operating time of laparoscopic and ERCP was 123.1 ± 33.4 minutes. The rate of successful surgeries was 93.2%, clearing stones was 87.8%. The rate of accident during the operation was 0%, early post-operative complications was 12.4%, death was 0%. The hospital stay after operating was 4.2 ± 2.8 (2 – 20 days). Outcomes classified when discharge were good 78.4%, rather good 14.8% and morderate 6.8%. Conclusion: The results of the gallbadder and bile duct gallstone patients treated with laparoscopic cholecystectomy and ERCP to remove the obstructive stones in the same general anesthesia were safe and feasible. Keywords: Gallstone, biliary lithiasis, laparoscopic cholecystectomy, endoscopic retrocholangiopancreatography.

Evaluation of the Safety and Efficacy of Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy for Treating Acute Complicated Cholecystitis

2018 ◽  
Vol 84 (1) ◽  
pp. 133-136 ◽  
Author(s):  
Baoxing Jia ◽  
Kai Liu ◽  
Ludong Tan ◽  
Zhe Jin ◽  
Yu Fu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Therapeutic Option ◽  
Combined Treatment ◽  
Operating Time ◽  
Optimal Time ◽  
Time Interval ◽  
Gallbladder Drainage ◽  
Conversion To Open Cholecystectomy ◽  
Percutaneous Transhepatic Gallbladder Drainage

The rate of acute cholecystitis in patients with severe underlying diseases is currently increasing. Several studies have reported percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) as a safe and reliable therapeutic option in such patients. This study aimed to elucidate the optimal time interval between PTGBD and LC. In total, 65 patients with acute complicated cholecystitis from our hospital were divided into two groups, short-term LC (sLC) and postponed LC (pLC) group according to whether the procedure was performed within 5 days of gallbladder drainage or after 5 days, respectively. The complications after PTGBD, rate of conversion to open surgery, and complications and mortality after LC were compared between the groups. The sLC group showed significantly lesser operating time, blood loss, postoperative peritoneal drainage time, postoperative oral intake time, and complications compared to the pLC group ( P < 0.05). Other factors such as the length of hospital stay (LOS), conversion to open cholecystectomy, and mortality were not statistically significant between the groups. Combined treatment with PTGBC and sLC showed superior outcomes compared to PTGBC and pLC for acute cholecystitis in severely ill patients, thus constituting a feasible and secure treatment option in specialized centers.

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