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- Title
Timing of Cholecystectomy after Emergent Endoscopic Retrograde Cholangiopancreatography for Cholangitis.
- Authors
SEVERANCE, SARAH E.; FEIZPOUR, CYRUS; FELICIANO, DAVID V.; COLEMAN, JAMIE; ZARZAUR, BEN L.; ROZYCKI, GRACE F.
- Abstract
Debate remains regarding the timing of laparoscopic cholecystectomy after emergent endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis. We hypothesized that patients undergoing early laparoscopic cholecystectomy would have fewer operative complications and a lower conversion rate. This study is a retrospective review of an ERCP database from 2012 to 2016 of adults with a diagnosis of cholangitis secondary to choledocholithiasis who underwent ERCP followed by a laparoscopic cholecystectomy. Patient demographics, ERCP details, timing of operation (<72 hours vs >72 hours after ERCP), complications, and mortality were recorded. Analysis included chi-square, Fisher's exact, and Wilcoxon rank-sum tests, where appropriate. In the 127 patients (65 per cent male; median age, 67 years; 48 (38%) early surgery), there were no differences in demographics, BMI, vital signs, or laboratory values. Patients in the late surgery group were more likely to have a Charlson Comorbidity Index > 3 (P = 0.002), require pre-operative endoscopic sphincterotomy (P < 0.002), need pre-operative insertion of a ductal stent (P < 0.03), and had more postoperative complications (P = 0.04). Patients in the late laparoscopic cholecystectomy group had more comorbidities and suffered more complications.
- Subjects
ENDOSCOPIC retrograde cholangiopancreatography; CHOLECYSTECTOMY; CHOLANGITIS; SURGICAL complications; VITAL signs; LAPAROSCOPIC surgery; MEDICAL care; PATIENTS; COMORBIDITY; RETROSPECTIVE studies; ACUTE diseases
- Publication
American Surgeon, 2019, Vol 85, Issue 8, p895
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481908500844