TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY AFTER ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

Aim: To evaluate the effect of timing of laparoscopic cholecystectomy (LC) on the conversion rate and the postoperative complications in patients of calcular obstructive jaundice after endoscopic retrograde cholangiopancreatography (ERCP). Methods: The study included all patients considered for elective LC after ERCP for calcular obstructive jaundice at The Department of General Surgery, Minia university hospital from January 2005 to January 2007. LC was planned and performed within 1 week (early group, 17 patients) or after 4 weeks (delayed group, 16 patients). Results: The conversion rate was 5.8% in the early group versus 56.2% in the delayed group (Chi-square test, P=0.006). The mean operative time in the early group was 70±33 versus 117±45 min in the delayed group (Unpaired student s t-test, P=0.0015). The mean length of hospital stay in the early group was 3±2.1 versus 7±3.5 days in the delayed group (Unpaired student s t-test, P=0.0003). The postoperative complication rate was 11.7% in the early group versus 62.5% in the delayed group (Chi-square tests, P=0.002). The mean follow-up period was 12±3.7 months. Conclusion: The early LC after ERCP is preferred than delayed cholecystectomy because it has low conversion rate, short operative time, short hospital stay and low rate of postoperative complications