A STUDY ON EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY STATUS POST ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

Abstract

Background: The optimal timing of laparoscopic cholecystectomy following endoscopic retrograde cholangiopancreatography (ERCP) remains controversial. Early surgery may reduce complications, but concerns regarding operative difficulty persist.

Objective: To compare operative and postoperative outcomes of early versus delayed laparoscopic cholecystectomy in patients undergoing ERCP for gallstone-related biliary disease.

Methods: This observational study included 76 patients, divided equally into early (within 24–72 hours) and delayed (after 4–6 weeks) laparoscopic cholecystectomy groups. Demographic, clinical, operative, and postoperative data were analyzed using appropriate statistical tests.

Results: Baseline characteristics were comparable between groups. Operative time >90 minutes was significantly higher in the delayed group (16; 42.1%) compared to the early group (4; 10.6%). Dense adhesions were observed in 18 (47.4%) delayed cases versus 8 (21.1%) early cases. Fibrosed gallbladder was more frequent in delayed surgery (16; 42.1%) compared to early (6; 15.8%). Conversion to open cholecystectomy occurred in 5 (13.2%) delayed cases and 1 (2.6%) early case. Postoperative complications were higher in the delayed group (12; 31.6%) compared to the early group (4; 10.5%). A greater proportion of early group patients had no complications (34; 89.5%) compared to delayed (26; 68.4%). Hospital stay ≤5 days was observed in 22 (57.9%) early cases versus 10 (26.3%) delayed cases.

Conclusion: Early laparoscopic cholecystectomy following ERCP is associated with improved surgical outcomes, reduced complications, and shorter hospital stay, supporting its role as the preferred management strategy.