Laparoscopic cholecystectomy and perioperative ERCP

Background/Aims: Study of acceptance of simultaneous laparoscopic cholecyst ectomy and endoscopic retrograde cholangiopancreatography for treatment of cholelithiasis with choledocholithiasis. Methodology: There were 25 patients. Ten patients had acute pancreatitis of biliary etiology, accompanied by transitory icterus. In 15 patients, chole docholithiasis was suspected preoperatively both on ultrasonography and i.v . cholangiography. In all patients laparoscopic cholecystectomy with periop erative endoscopic retrograde cholangiopancreatography and sphincterotomy w ere performed for the treatment of cholelithiasis and choledocholithiasis. Results: Simultaneous laparoscopic cholecystectomy and endoscopic retrograd e cholangiopancreatography was successfully done in all patients. The patie nts were discharged home on the 4th day after the surgery. Concerning early complications, there where 3 early complications, e.g., prolonged hemorrha ge after papillotomy in a patient with choledocholithiasis with stenotic pa pillitis. Conservative therapy (fresh frozen plasma, local hemostats) was u sed in this patient. In 4 patients with choledocholithiasis, transitory hyp eramylasemia was observed, with no clinical symptoms of pancreatitis. The s ymptoms disappeared with conservative therapy 3 days after the beginning of treatment. Conclusions: Simultaneous laparoscopic cholecystectomy and endoscopic retro grade cholangiopancreatography for treatment of cholelithiasis and choledoc holithiasis is a safe and acceptable treatment.