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- W2551815329 abstract "Background: Laparoscopic cholecystectomy (LC) is the standard treatment following ERCP & Endoscopic Sphincterotomy (ES) for CBD stones and gall stone pancreatitis. This surgery may be difficult needing longer operating times with risk for conversion and bile duct injury. We analyzed factors which could be overcome to minimize complications. Methods: We evaluated all cases from 2008 to 2014 who underwent LC following ERCP & ES. The time interval between the two procedures was noted along with pre-operative and intraoperative factors making surgery difficult or leading to conversion. The difficulty in handling the gall bladder, changes in Calot’s triangle anatomy and appropriate technical modifications in the approach were documented. Results: The study analyzed 56 patients who underwent LC following ERCP & ES. Changes in anatomy observed were a frozen Calot’s triangle in 32 cases, short and wide cystic duct difficult to clip in 22 cases, difficult to handle gall bladder in 36 cases, lateral rent in the cystic duct in 8 cases, an adherent cystic duct and CHD like in Mirrizzi syndrome in 10 cases. 3 cases had bile duct injuries and 8 cases were converted. Discussion: LC after ERCP & ES is often a technical challenge. The surgeon can educate the patient regarding the anticipated difficulties and the need for long operating times or conversion in advance. Meticulous dissection close to gall bladder with a ligature for handling ensures opening of cystohepatic triangle. Wide cystic duct requires ligation. The timing of the surgery after ERCP & ES should be within 48-72 hours to reduce the difficulty which may otherwise arise in delayed cases." @default.
- W2551815329 created "2016-11-30" @default.
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- W2551815329 date "2015-01-01" @default.
- W2551815329 modified "2023-09-27" @default.
- W2551815329 title "Pre-Operative ERCP Is a Significant Difficulty Predictor For Laparoscopic Cholecystectomy - An Analysis" @default.
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- W2551815329 hasPublicationYear "2015" @default.
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