Clinical Trial of Early vs Delayed Laparoscopic Cholecystectomy After CBD Stone Clearance

Early vs Delayed Laparoscopic Cholecystectomy After CBD Stone Clearance

Abstract

Background: The aim is to compare early vs delayed laparoscopic cholecystectomy after CBD stone clearance. Subjects andMethodology: 68 adult patients who underwent ERCP for concomitant gallstones and CBD stones were divided into 2 groups of 34 each. Group I was early cholecystectomy group underwent surgery within 72 hours of ERCP and in group II, the delayed group underwent surgery after 6 weeks of ERCP. Results: There were 22 males in group I and 20 in group II and 12 females in group I and 14 in group II. In group I and group II, the mean operative time was 46.3 minutes and 67.2 minutes respectively. Nassar scale was grade 1 in 20 and 7, grade 2 was seen in 10 and 4, grade 3 was seen in 3 and 15, grade 4 was seen in 1 and 8 respectively (P< 005). Adhesion grade 1 was seen in 15 and 6, grade 2 was seen in 10 and 8, grade 3 was seen in 5 and 9 and grade 4 was seen in 4 and 11 respectively. Cholecystitis was seen in 26 and 12, dissection difficulty was seen in 8 and 19 and bleeding was seen in 4 and 11 respectively. The mean hospital stay was 32.4 hours sin group I and 40.2 hours in group   II, bac to work was 14.2 days in group I and 17.6 days in group II, pain on numerical rating scale was 4.3 in group I and in group II was 4.9. Fever was present was 2 in group I and 4 in group II and wound complication was present in 1 in group I and 3 in group II. Conclusion: Early laparoscopic cholecystectomy after ERCP is better treatment option as compared to delayed cholecystectomy in terms of less operative time, less intraoperative difficulties.