Endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy for treatment of cholecystocholedocholithiasis: single session versus two session management

  • Mohammed Khalil Elamaary
  • Asmaa Gaber R
  • Mohammed A. Omar
  • Ahmed Himhamy
Keywords: endoscopic retrograde cholangiopancreatography (ERCP), laparoscopiccholecystectomy, CBD stones


Background: Endoscopic retrograde cholangiopancreatography (ERCP) in a single-step
treatment of common bile duct (CBD) stones during laparoscopic cholecystectomy also benefits
the patient by reducing the treatment from a two-step procedure to a single-step procedure under
general anesthesia. It minimizes the risk of induction of pancreatitis and avoids exploration of the
Objective: To evaluate safety and efficacy of same-session endoscopic retrograde
cholangiopancreatography and laparoscopic cholecystectomy.
Patients and Methods: Study carried out on patients who attended to General Surgery
Department, Qena University Hospital complaining of cholecystocholedocholithiasis, in the
period from April 2017 to April 2018
Results: The age ranged from 20-66 years. The technique was successful in all the 40 patients.
Stone extraction was done by use of balloon in 15 patients (75%) in group 1 and in 13 patients
(65%) in group 2, and by the use of dormie extraction in 5 patients (25%) in group 1 and in 4
patients (20%) in group 2.
The mean operative time in the early group was 39 ±3 min versus 55±3 min in the delayed group
(p = 0.001).
The mean length of hospital stay in the early group was 3.35 ± 0.489 versus 5.6 ± 1.188 days in
the delayed group (p = 0.006). The conversion rate was 0 case (0%) in the early group versus 3
cases (15%) in the delayed group. It was significantly higher in the delayed group. Pancreatitis
was detected in 2 cases in group 2.
Conclusion: Immediate LC post ERCP is possible and safe procedure.