Optimal timing for laparoscopic cholecystectomy after endoscopic sphincterotomy / 中华肝胆外科杂志

ABSTRACT

Objective To determine whether it is better to carry out laparoscopic cholecystectomy (LC) immediately or 3 days after endoscopic sphincterotomy (EST) in patients with common bile duct stones and gallbladder stones.Methods A retrospective study was conducted on 160 patients who had common bile duct stones and gallbladder stones treated from July 2013 to July 2015 in the First People's Hospital of Huizhou.These patients were divided into a control group and an observation group,with 80 patients in each group.The control group underwent LC immediately after EST,while the observation group underwent LC 3 days after EST.The levels of blood amylase before LC,operation time,intraoperative bleeding volume,postoperative time to first flatus,postoperative complication after EST,postoperative hospitalization stay,total hospitalization stay and total hospital costs and incidences of postoperative complication after LC were compared between the two groups.Results The time periods of total hospitalization stay in the observation group and the control group were (18.2 ±3.5) d and (12.3 ±3.0) d,respectively (P＜0.05).The total costs in the two groups were (32 164 ±9 125) RMB and (22 375 ±7 860) RMB,respectively (P ＜ 0.05).The overall incidences of postoperative complication [patients (％)] were 5 (6.3) and 9 (11.3),respectively (P ＜ 0.05).The differences on preoperative serum amylase levels,LC operative time,blood loss,postoperative time to first flatus and postoperative hospitalization stay were not significantly different (P ＞ 0.05).Conclusion LC carried out on day 3 after EST to treat common bile duct stones and gallbladder stones was clinically more efficacious.