Ann Surg Treat Res.  2016 Jun;90(6):309-314. 10.4174/astr.2016.90.6.309.

Who experiences endoscopic retrograde cholangiopancreatography after laparoscopic cholecystectomy for symptomatic gallstone disease?

• Kim BS
• Joo SH
• Cho S
• Han MS

• KMID: 2164791
• DOI: http://doi.org/10.4174/astr.2016.90.6.309

Abstract

PURPOSE
Laparoscopic cholecystectomy (LC) has become a standard treatment of symptomatic gallstone disease. But, some patients suffer from retained common bile duct stones after LC. The aim of this study is to analyze the predicting factors associated with subsequent postoperative endoscopic retrograde cholangiopancreatography (ERCP) after LC.
METHODS
We retrospectively reviewed a database of every LC performed between July 2006 and September 2012. We classify 28 patients who underwent ERCP within 6 months after LC for symptomatic gallstone disease as the ERCP group and 56 patients who underwent LC for symptomatic gallstone disease during same period paired by sex, age, underlying disease, operation history, and body mass index as the control group. To identify risk factor performing postoperative ERCP after LC, we compared admission route, preoperative biochemical liver function test, number of gall stones, gallstone size, adhesion around GB, wall thickening of GB, and existence of acute cholecystitis between the 2 groups.
RESULTS
Admission route, preoperative AST, ALT, and ALP, stone size, longer operation time, and acute cholecystitis were identified as risk factors of postoperative ERCP in univariate analyses. But, longer operation time (P = 0.004) and acute cholecystitis (P = 0.048) were identified as independent risk factors of postoperative ERCP in multivariate analyses.
CONCLUSION
The patient who underwent ERCP after LC for symptomatic gallstone disease are more likely experienced longer operation time and acute cholecystitis than the patient who did not undergo ERCP after LC.

Keyword

Laparoscopic cholecystectomy; Endoscopic retrograde cholangiopancreatography; Common bile duct stones

MeSH Terms

Body Mass Index
Cholangiopancreatography, Endoscopic Retrograde*
Cholecystectomy, Laparoscopic*
Cholecystitis, Acute
Common Bile Duct
Gallstones*
Humans
Liver Function Tests
Multivariate Analysis
Retrospective Studies
Risk Factors

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