Comparison of early and delayed laparoscopic cholecystectomy in patients undergoing ERCP for choledocholithiasis

Objective: This study aims to evaluate the impact of the timing of cholecystectomy on surgical and clinical outcomes in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. Methods: This prospective clinical study was conducted in the Department of General Surgery at Harran University Faculty of Medicine. A total of 100 patients who underwent elective cholecystectomy following ERCP were included and divided into two groups: early surgery (n=50) and delayed surgery (n=50). Demographic data, laboratory parameters, perioperative findings, and postoperative outcomes were systematically recorded and statistically analyzed to compare the groups. Results: No statistically significant differences were observed between the groups regarding age, gender, or body mass index (p>0.05). Although the biochemical parameters measured prior to ERCP were comparable between the groups, preoperative levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, direct bilirubin, gamma-glutamyl transferase (GGT), and C-reactive protein (CRP) were significantly elevated in the early surgery group (p<0.001). The early surgery group had a significantly shorter operative time (p<0.001), lower drain output (p=0.007), and a significantly lower incidence of pericholecystic adhesions (p<0.001). Although the rates of conversion to laparotomy and gallbladder perforation were higher in the delayed surgery group, these differences were not statistically significant (p=0.081 and p=0.118, respectively). A trend toward shorter hospital stay and earlier drain removal was observed in the early surgery group; however, these differences did not reach statistical significance. Conclusion: Early cholecystectomy following ERCP offers notable surgical advantages, including