Effect of ERCP burden on outcomes of subsequent laparoscopic cholecystectomy
4 affiliations
- 1General Surgery Department, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
- 2General Surgery Department, Kaş Medical Center, Istanbul, Türkiye
- 3General Surgery Department, Medicana Atakoy Hospital, Istanbul, Türkiye
- 4General Surgery Department, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Türkiye
Abstract
Background: Laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreatography (ERCP) is commonly performed in patients with concomitant gallbladder and common bile duct stones. However, the impact of ERCP-related factors on the technical difficulty and outcomes of LC remains unclear. This study aimed to evaluate the association between prior ERCP exposure and subsequent LC outcomes and to investigate the role of ERCP-related procedural factors.
Methods: Patients who underwent LC were retrospectively divided into ERCP and non-ERCP groups. To minimize baseline differences, propensity score matching (PSM) (1:1) was performed based on age, sex and ASA score. Following matching, perioperative outcomes were compared between groups to evaluate the impact of prior ERCP. Subgroup analyses within the ERCP cohort were performed according to ERCP-related variables, including indication, ERCP-LC interval, number of ERCP procedures, stone extraction and biliary stenting.
Results: A total of 426 patients were included in the study. Following PSM, the rate of laparoscopic subtotal cholecystectomy (LSC) was significantly higher in patients with prior ERCP compared with controls (p = 0.003), whereas conversion to open surgery was similar between groups (p = 0.996). Within the ERCP cohort, patients who underwent ≥ 3 ERCP procedures or received ≥ 2 biliary stents had significantly higher rates of LSC (p = 0.004 and p = 0.008, respectively). Multiple stone extraction was associated with longer operative time in subgroup analyses. In multivariable analysis, ≥ 3 preoperative ERCP procedures were associated with LSC (OR 15.98, 95% CI 2.70–94.39; p = 0.002). This finding was consistent in a secondary sensitivity model including fewer covariates, in which repeated ERCP procedures remained significantly associated with LSC.
Conclusion: Prior ERCP is associated with increased operative difficulty during subsequent laparoscopic cholecystectomy. Among ERCP-related factors, repeated ERCP procedures, particularly undergoing three or more preoperative ERCP interventions, were associated with a higher likelihood of laparoscopic subtotal cholecystectomy. These findings suggest that cumulative ERCP burden may be associated with increased difficulty of subsequent laparoscopic cholecystectomy.
Related
- When should a laparoscopic cholecystectomy be performed after ERCP for common bile duct stones combined with gallbladder stones? A meta-analysis of randomized controlled trials.
- Early Laparoscopic Cholecystectomy for Acute Gallstone Pancreatitis: Retrospective Review of Factors Influencing Timing of Surgery and Outcomes in a Single Institution
- Laparoscopic-assisted ERCP is a safe procedure with good outcomes: experience from a single high-volume upper GI unit
- Thirty-day clinical outcomes, early recovery, and healthcare resource use after planned ambulatory vs. conventional inpatient laparoscopic cholecystectomy: a propensity-score overlap-weighted retrospective cohort study
- Relationship Between Gallbladder Wall Thickness and Perioperative Outcomes in Patients Undergoing Laparoscopic Cholecystectomy.
BibTeX
@article{kesgin2026effect,
title = {{Effect of ERCP burden on outcomes of subsequent laparoscopic cholecystectomy}},
author = {Yasir Musa Kesgin and Alpen Yahya Gumusoglu and Hamit Ahmet Kabuli and Nigar Aktash and Sezer Bulut and Ali Kocataş and Mehmet Karabulut and Gökhan Tolga Adaş},
journal = {BMC Surgery},
year = {2026},
month = sep,
doi = {10.1186/s12893-026-04135-0},
url = {https://doi.org/10.1186/s12893-026-04135-0},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Effect of ERCP burden on outcomes of subsequent laparoscopic cholecystectomy
AU - Yasir Musa Kesgin
AU - Alpen Yahya Gumusoglu
AU - Hamit Ahmet Kabuli
AU - Nigar Aktash
AU - Sezer Bulut
AU - Ali Kocataş
AU - Mehmet Karabulut
AU - Gökhan Tolga Adaş
PY - 2026
DA - 2026/09/05
JO - BMC Surgery
DO - 10.1186/s12893-026-04135-0
UR - https://doi.org/10.1186/s12893-026-04135-0
AB - Background: Laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreatography (ERCP) is commonly performed in patients with concomitant gallbladder and common bile duct stones. However, the impact of ERCP-related factors on the technical difficulty and outcomes of LC remains unclear. This study aimed to evaluate the association between prior ERCP exposure and subsequent LC outcomes and to investigate the role of ERCP-related procedural factors. Methods: Patients who underwent LC were retrospectively divided into ERCP and non-ERCP groups. To minimize baseline differences, propensity score matching (PSM) (1:1) was performed based on age, sex and ASA score. Following matching, perioperative outcomes were compared between groups to evaluate the impact of prior ERCP. Subgroup analyses within the ERCP cohort were performed according to ERCP-related variables, including indication, ERCP-LC interval, number of ERCP procedures, stone extraction and biliary stenting. Results: A total of 426 patients were included in the study. Following PSM, the rate of laparoscopic subtotal cholecystectomy (LSC) was significantly higher in patients with prior ERCP compared with controls (p = 0.003), whereas conversion to open surgery was similar between groups (p = 0.996). Within the ERCP cohort, patients who underwent ≥ 3 ERCP procedures or received ≥ 2 biliary stents had significantly higher rates of LSC (p = 0.004 and p = 0.008, respectively). Multiple stone extraction was associated with longer operative time in subgroup analyses. In multivariable analysis, ≥ 3 preoperative ERCP procedures were associated with LSC (OR 15.98, 95% CI 2.70–94.39; p = 0.002). This finding was consistent in a secondary sensitivity model including fewer covariates, in which repeated ERCP procedures remained significantly associated with LSC. Conclusion: Prior ERCP is associated with increased operative difficulty during subsequent laparoscopic cholecystectomy. Among ERCP-related factors, repeated ERCP procedures, particularly undergoing three or more preoperative ERCP interventions, were associated with a higher likelihood of laparoscopic subtotal cholecystectomy. These findings suggest that cumulative ERCP burden may be associated with increased difficulty of subsequent laparoscopic cholecystectomy.
SN - 1471-2482
ER -