JOCS
Journal of Comprehensive Surgery

The aim of the Comprehensive Surgery is to publish original research articles of the highest scientific and clinical value at the international level in all surgical fields. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

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Original Article
Comparative analysis of surgical outcomes: post-ERCP laparoscopic cholecystectomy versus elective laparoscopic cholecystectomy
Abstract
Aims: Gallstones are widespread in the adult population. In some patients, the stones are not confined to the gallbladder but are also found in the biliary tract. Although the treatment approach for this group of patients is controversial, the most widely accepted treatment is laparoscopic cholecystectomy (LC) after removal of the stones by endoscopic retrograde cholangiopancreaticography (ERCP). Opinions differ as to whether LC should be performed early or late. With this study, we wanted to shed light on this question based on our own clinical experience.
Methods: A total of 100 patients who underwent LC in our clinic were included in the study. These patients were divided into two groups: 50 patients who underwent ERCP and early cholecystectomy (group 1) and 50 patients who underwent elective LC for gallstones (group 2). Patients who underwent ERCP for malignant or benign stricture, patients with porcelain sac, patients with previous abdominal surgery, patients who underwent emergency LC, patients younger than 18 years old, and patients with incomplete data, incomplete records, or patients whose necessary information could not be accessed were excluded.
Results: There was no statistically significant difference between age and preoperative amylase levels. The mean length of hospital stay was 3.9±1.6 days in patients who underwent elective LC and 5.5±3.2 days in patients who underwent LC after ERCP. There was a statistically significant difference between postoperative amylase level, hemoglobin level and length of hospital stay (p<0.05). Postoperative amylase levels and length of hospital stay were higher in group 1. There was a significant difference between the groups in terms of surgical procedure (p<0.05). In group 1, laparoscopic cholecystectomy (LC) was performed in 76% of patients, while in group 2, LC was performed in 94% of patients. It was found that the rate of conversion to patency was higher in group 1. There was no statistically significant difference between the groups in terms of postoperative and preoperative complications
Conclusion: In conclusion, our study highlights early cholecystectomy after ERCP to reduce potential complications in the treatment of gallstones, while emphasising the need for close patient follow-up and further research validation.

Keywords : Post-ERCP laparoscopic cholecystectomy, elective laparoscopic cholecystectomy, ERCP, cholecystectomy, gallbladder stone, bile duct stone

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1. Matsumoto K, Noma H, Fujita K, et al. Prognostic factors for severe-to-fatal post-endoscopic retrograde cholangiopancreatography pancreatitis: a multicenter prospective cohort study. J Clin Med. 2024; 13(4):1135. doi: 10.3390/jcm13041135
2. Obaitan I, Mohamed MFH, Beran A, et al. Comparative risks of post-ercp adverse events in patients with asymptomatic and symptomatic choledocholithiasis: a systematic review and meta-analysis. Dig Dis Sci. 2024;69(5):880-1888. doi: 10.1007/s10620-024-08374-0
3. Atamanalp SS, Yıldırgan MI, Kantarcı A. Endoscopic retrograde cholangiopancreatography (ERCP) outcomes of 3136 cases over 10 years. Turk J Med Sci. 2011;41(4):615-621.
4. Mutlu N, Bolat R, Yorulmaz F, et al. Endoskopik retrograd kolanjio pankreatografi (ERCP). G&uuml;ncel Gastroenterol. 2005;10(1):120-123.
5. Keil R, Snajdauf J, Rygl M, et al. Diagnostic efficacy of ERCP in cholestatic infants and neonates-a retrospective study on a large series. Endoscopy. 2010;42(2):121-126.
6. Joseph D, Muraleedharanpillai R, Kolassery S, Sebastian S. Clinical profiles and outcomes of patients undergoing endoscopic retrograde cholangiopancreatography in a tertiary care center. Cureus. 2024;16(2): e55065. doi: 10.7759/cureus.55065.
7. Huang LY, Liu YX, Wu CR, et al. Application of endoscopic retrograde cholangiopancreatography in biliary-pancreatic diseases. Chinese Med J. 2009;122(24):2967-2972.
8. Meng ZW, Ruan Y, Fisher S, et al. Development and validation of a practical clinical risk prediction model for post-endoscopic retrograde cholangiopancreatography pancreatitis. DEN Open. 2024;4(1):e355. doi: 10.1002/deo2.355
9. Laokpessi A, Bouillet P, Sautereau D, et al. Value of magneticresonance cholangiography in the preoperative diagnosis ofcommon bile duct stones. Am J Gastroenterol. 2001;96(8):2354-2359.
10. &Ouml;zcan &Ouml;, Arikan S. Determining the risk factors of complications due to endoscopic retrograde cholangiopancreatography. Cureus. 2024;16(1):e51666.
11. Stefanova I, Kyle E, Wilson I, Tobbal M, Veeramootoo D, De&rsquo;Ath HD. Laparoscopic cholecystectomy vs endoscopic retrograde cholangiopancreatography with sphincterotomy in elderly patients with acute gallstone pancreatitis. Am Surg. 2024:31348241248564. doi: 10.1177/ 00031348241248564
12. The Gastroenterology Leadership Council. Training the gastroenterologist of the future: the gastroenterology core curriculum. Gastroenterology. 1996;110(4):1266-1300.
13. Jowell PS, Branch S, Robuck F Mangum G, Fein S, Purich ED. Synthetic secretin administered at the start of the procedure significantly reduces the risk of post-ERCP pancreatitis: a randomized, double blind, placebo controlled trial. Gastroenterol. 2003;125:605.
14. Vitale GC, Zavalete CM, Vitale DS, Binford JC. Training surgens in endoscopic retrograde cholangiopankreatograhy. Surg Endosc. 2006; 20(1):149-152.
15. Penaloza-Ramirez A, Leal-Buitrago C, Rodriguez-Hernandez A. Adverse events of ERCP at San Jose Hospital of Bogota (Colombia). Rev Esp Enferm Dig. 2009;101(12):837-849.
16. Freeman ML, DiSario JA, Nelson DB, et al. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc. 2001;54(4):42534.
17. Lee SJ, Song KS, Chung JP, et al. Type of electric currents used for standard endoscopic sphincterotomy does not determine the type of complications. Korean J Gastroenterol. 2004;43(3):204-210.
18. Wurbs D. The development of biliary drainage and stenting. Endoscopy. 1998;30(9):A202-A206.
19. Heo J, Jung MK, Lee J, Lee DW, Cho CM, Cha JG. Comparative study between biliary covered self-expandable metal stent and conventional endoscopic bile drainage treatment in endoscopic retrograde cholangiopancreatography-related Stapfer type II retroperitoneal perforations. PLoS One. 2024;19(3):e0300029. doi: 10.1371/journal.pone.0300029
20. Freeman ML. Adverse outcomes of endoscopic retrograde cholangiopancreatography. Gastrointest Endosc. 2002;56(6):273-282.
21. Chistoforidis E, Goulimaris I, Kanellos I, Tsalis K, Demetriades C, Betsis D. Post ERKP pancreatitis and hyperamylasemia: patient related and opera tive risk factors. Endoscopy. 2002;34(4):286-292.
22. Bergman JJ, Rauws EA, Fockens P, et al. Randomised trial of endoscopi balloon dilation versus endoscopic sphincterotomy for removal of bile duct stones. Lancet. 1997;349(9059):1124-1129.
23. Britton J. Biliary and pancreatic endoscopy. In: Morris PJ, Wood WC, eds. Oxford Textbook of Surgery. 2nd ed. Lippincott Williams&amp; Wilkins: 2000:551-558.
24. Zhou PH, Yao LQ, Xu MD. Application of needle knife in difficult biliary cannulation for endoscopic retrograde cholangiopancreatography. Hepatobiliary Pancreat Dis Int. 2006;5(4):590-594.
25. George S, Kulkarni AA, Stevens G, Forsmark CE, Draganov P. Role of osmolality of contrast media in the development of post-ERCP pancreatitis: a metanalysis. Dig Dis Sci. 2004;49(3):503
26. Tokumura H, Umezawa A, Cao H, et al. Laparoscopic management of common bile duct stones: transcystic approach and choledochotomy. J Hepatobiliary Pancreat Surg. 2002;9(2):206-212.
27. Gurusamy KS, Samraj K. Primary closure versus T-tube drainage afterlaparoscopic common bile duct stone exploration. Cochrane Database Syst Rev. 2007;24(1):CD005641.
28. Zhu QD, Tao CL, Zhou MT, Yu ZP, Shi HQ, Zhang QY. Primary closure versus T-tube drainageafter common bile duct exploration for choledocholithiasis. Langenbecks Arch Surg. 2011;396(1):53-62.
29. Yamazaki M, Yasuda H, Tsukamoto S, et al. Primary closure of thecommon bile duct in open laparotomy for common bile duct stones. J Hepatobiliary Pancreat Surg. 2006;13(5):398-402.
30. Tarnasky PR, Palesch YY, Cunningham JT, Mauldin PD, Cotton PB, Hawes RH. Pancreatic stenting prevents pancreatitis after biliary sphincterotomy in patients with sphincter of Oddi dysfunction. Gastroenterol. 1998;115(6):1518-1524.
31. Akat AZ, Doğanay M, Koloğlu M, G&ouml;zalan U, Dağlar G, Kama NA. Tek merkezde yapılan 1000 vakada laparoskopik kolesistektominin değerlendirilmesi. T&uuml;rkiye Klin J Med Sci. 2002;22(2):133-141.
32. Ahmed I, Pradhan C, Beckingham IJ, Brooks AJ, Rowlands BJ, Lobo DN. Is a T-tube necessary aftercommon bile duct exploration? World J Surg. 2008;32(7):1485.
33. Sarıtaş &Uuml;, G&ouml;ren İ, Şenol A. Risk factors for complications of therapeutic ERCP: a single center prospective study. Akad Gastroent Derg. 2006;5(3):163-168.
34. Cahyadi O, Tehami N, de-Madaria E, Siau K. Post-ERCP pancreatitis: prevention, diagnosis and management.Medicina.2022;58(9):1261.
35. Leida Z, Ping B, Shuguang W, Yu H. A randomized comparison ofprimary closure and T-tube drainage of the common bile duct after laparoscopic choledochotomy. Surg Endosc. 2008;22(7):1595-1600.
36. Yılmaz S, Bal A, &Ouml;zke&ccedil;eci T, Sıvacı R, Baki ED, Ahsen A. ERCP sonu&ccedil;larımız: genel cerrahi kliniğinde yapılan 703 olguluk ERCP deneyimi. 18. Ulusal Cerrahi Kongresi. 23-27 Mayıs 2012. İzmir.
37. Akın ML, Erenoğlu C, Filiz E, Batkın A. Laparoskopik kolesistektomi sonrasında oluşan intraoperatif min&ouml;r komplikasyonların tedavisi. End-Lap Min İnv Cerr Derg. 1998;5:91-95.
38. Alabaz &Ouml;, S&ouml;nmez H, Erko&ccedil;ak EU, Camcı C, Dalyan O. Laparoskopik kolesistektomi:192 olgunun sunumu. End-Lap Min İnv Cerr Derg. 1996;3:94-99.
39. Ağalar F, &Ouml;zdemir A, Sayek, et al. Laparoskopik kolesistektomi: 500 olgunun incelenmesi-Hacettepe deneyimi. End-Lap Minimal İnv Cerr Derg. 1996;3:100-106.
Article available in :
Volume 2, Issue 2, 2024
Page : 21-28
https://doi.org/10.51271/JOCS-0029
Article Information
Received : 05 May 2024
Accepted : 20 May 2024
Published : 29 May 2024
Corresponding Author :

Mustafa Kalkan: Department of General Surgery, Adıyaman Training and Research Hospital, Adıyaman, Turkiye

[email protected]
Citation : Kalkan M, Arıkan Y, Yılmaz S, Çelep RB. Comparative analysis of surgical outcomes: post-ercp laparoscopic cholecystectomy versus elective laparoscopic cholecystectomy. J Compr Surg. 2024;2(2):21-28.

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