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Laparoscopic cholecystectomy is the standard treatment for acute cholecystitis. In patients who also have choledocholithiasis, endoscopic retrograde cholangiopancreatography is the treatment of choice. In some studies, it has been reported that, after this endoscopic examination, laparoscopic cholecystectomy is more difficult, and conversion rates, bleeding and operative time are higher. The objective of this study was to determine whether laparoscopic cholecystectomies after this endoscopic procedure present more postoperative complications and greater technical difficulty in our setting. Methods: Prospective cohort study, in which a group of patients who underwent laparoscopic cholecystectomy prior endoscopic retrograde cholangiopancreatography was compared against a homogeneous group of patients without previous cholangiography, to assess the difficulty of laparoscopic cholecystectomy, conversion, reoperation and complications. Results: 45.4 % of the surgeries were difficult. There is no relationship between the previous performance of ERCP and the difficulty of laparoscopic cholecystectomy. With the logistic regression model, age, male gender, previous abdominal surgery, acute cholecystitis and greater degree of severity of acute cholecystitis were found as predictive factors for difficult surgery. Conclusion: ERCP in our setting is not a risk factor for difficult laparoscopic cholecystectomy. Special care should be taken to the male gender, the severity of acute cholecystitis, the history of abdominal surgery and the presence of comorbidities when planning a laparoscopic cholecystectomy, taking additional precautions in these cases to prevent complications.

revista colombiana de cirugía

¿Es más difícil la colecistectomía laparoscópica después de una colangiopancreatografía retrógrada endoscópica? Experiencia en un hospital de tercer nivel