Single-Stage Endoscopic Stone Extraction and Cholecystectomy during the Same Hospitalization

Area of Science:

• Gastroenterology
• Surgical Innovation

Background:

• The clinical impact of combining endoscopic retrograde cholangiopancreatography (ERCP) with cholecystectomy in a single hospitalization for cholangitis is not well-established.
• Choledocholithiasis secondary to cholecystolithiasis frequently causes mild to moderate cholangitis, necessitating effective treatment strategies.

Purpose of the Study:

• To evaluate the efficacy and safety of single-stage ERCP and cholecystectomy during the same hospitalization.
• To assess the feasibility of this combined approach in patients with cholangitis.

Main Methods:

• Retrospective review of 166 patients with mild to moderate cholangitis due to choledocholithiasis undergoing ERCP between 2012 and 2016.
• Comparison of outcomes between patients who had cholecystectomy during the same hospitalization versus those with delayed cholecystectomy.

Main Results:

• Complete stone extraction via ERCP was achieved in 92% of patients.
• Cholecystectomy was performed during the same hospitalization in 89% of eligible patients.
• No significant differences in operative time, postoperative complications, or length of stay were observed between same-day and delayed cholecystectomy groups.

Conclusions:

• Single-stage endoscopic stone extraction is recommended for mild to moderate acute cholangitis caused by choledocholithiasis.
• Combining ERCP stone extraction and cholecystectomy in the same hospitalization is a safe and feasible strategy.