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Published on: September 13, 2022
Effect of Cholecystectomy on ERCP Cannulation and Postoperative Complications in Patients With Choledocholithiasis: A
Jixing Wang1, Zhenhao Huang, Qihui Hu
1Department of Hepatobiliary Surgery, Bishan Hospital of Chongqing Medical University, Chongqing, China.
Background:
Limited studies have examined cholecystectomy's impact on endoscopic retrograde cholangiopancreatography (ERCP) cannulation success and complications in patients with choledocholithiasis. This study used propensity score matching (PSM) to evaluate how cholecystectomy history affects these outcomes during ERCP for choledocholithiasis.
Methods:
This retrospective study enrolled 806 choledocholithiasis patients undergoing ERCP at Bishan Hospital, Chongqing Medical University (February 2018 to July 2024). Based on cholecystectomy history, patients were stratified into cholecystectomy and noncholecystectomy groups. With difficult biliary cannulation [European Society of Gastrointestinal Endoscopy (ESGE) criteria] as the primary endpoint, 1:1 propensity score matching (PSM) balanced intergroup covariates. Univariate and multivariate logistic regression analyses systematically evaluated the impact of cholecystectomy history on difficult cannulation and postoperative complications.
Results:
Before matching (Cholecystectomy: n=146; Noncholecystectomy: n=660), groups differed significantly in gender, ALT, AST, TBiL, and DBiL (all P <0.05). After PSM (n=290), covariates were balanced. Multivariate analysis revealed cholecystectomy history, age, and gender as independent predictors of cannulation success.
Conclusions:
Patients with prior cholecystectomy undergoing ERCP for choledocholithiasis demonstrated significantly lower rates of difficult cannulation compared with those without cholecystectomy history, without significant increase in postoperative complications.
