TY - JOUR
T1 - Timing of cholecystectomy after emergent endoscopic retrograde cholangiopancreatography for cholangitis
AU - Severance, Sarah E.
AU - Feizpour, Cyrus
AU - Feliciano, David V.
AU - Coleman, Jamie
AU - Zarzaur, Ben L.
AU - Rozycki, Grace F.
N1 - Funding Information:
We would like to acknowledge and thank the Regenstrief Institute at Indiana University for assistance with patient identification, database query, and data management.
Publisher Copyright:
© 2019 Southeastern Surgical Congress. All rights reserved.
PY - 2019
Y1 - 2019
N2 - 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 5 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 5 0.04). Patients in the late laparoscopic cholecystectomy group had more comorbidities and suffered more complications.
AB - 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 5 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 5 0.04). Patients in the late laparoscopic cholecystectomy group had more comorbidities and suffered more complications.
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M3 - Article
C2 - 31560309
AN - SCOPUS:85072614809
SN - 0003-1348
VL - 85
SP - 895
EP - 899
JO - American Surgeon
JF - American Surgeon
IS - 8
ER -