Endoscopy 2019; 51(04): S16-S17
DOI: 10.1055/s-0039-1681216
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: ERCP stones Club H
Georg Thieme Verlag KG Stuttgart · New York

CLINICAL IMPACT OF PREOPERATIVE RELIEF OF JAUNDICE FOLLOWING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY ON DETERMINING OPTIMAL TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY

SW Yi
1   Internal Medicine, Yonsei University/Severance Hospital, Gyeonggido, Korea, Republic of
,
KH Paik
2   Internal Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, Daejeon, Korea, Republic of
,
WH Paik
3   Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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    Aims:

    About 10% of patients with cholecystolithiasis also have concomitant choledocholithiasis. Laparoscopic cholecystectomy (LC) preceded by preoperative endoscopic retrograde cholangiopancreatography (ERCP) is the most commonly practiced strategy worldwide for managing co-existing gallbladder and common bile duct stones. In this study, we evaluated the optimal timing of LC according to clinical factor, focusing on preoperative relief of jaundice.

    Methods:

    A total of 153 patients who underwent elective LC after ERCP because of choledocholithiasis and cholecystolithiasis from January 2010 to April 2014 were retrospectively reviewed. We compared hospital stay, perioperative morbidity, and rate of surgical conversion to open cholecystectomy according to relief of jaundice before surgery. These enrolled patients were divided into two groups: relief of jaundice before surgery (group 1, n = 76) or not (group 2, n = 77).

    Results:

    There were no significant differences in age, sex distribution, American Society of Anesthesiologists score, previous surgical history, white blood cell count, c-reactive protein, or operative time between the two groups. There was no significant difference in postoperative hospital stay between the two groups (4.9 ± 3.2 vs. 6.0 ± 5.2 days, p = 0.103). There were no statistical differences in conversion rate (3.9% vs. 5.4%, p = 0.717) or perioperative morbidity (0.0% vs. 3.9%, p = 0.125) either.

    Conclusions:

    LC would not be delayed until relief of jaundice after ERCP since there were no significant differences in perioperative morbidity or surgical conversion rate to open cholecystectomy. Early LC after ERCP may be feasible and safe in patients with acute cholangitis and cholecystolithiasis.