الفهرس 
Surgical Anatomy of gall bladder and biliary treeOnly 14 pages are availabe for public view
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Abstract
Background: Laparoscopic cholecystectomy (LC) post Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy(ES) is generally accepted as the treatment of choice for patient with choledococystolithiasis. Previous studies have shown that LC after ERCP is associated with a high conversion rate. The aim of the present study was to assess the complexity of LC after ERCP compared with standard LC for symptomatic uncomplicated cholecystolithiasis.
Objectives: So the aim of this study is to assess the complexity of LC post ERCP comparted to elective LC without previous ERCP.
Method: The study is a prospective cohort study of two groups of patients: patients who had undergone a previous ERCP for choledocolithiasis (PES) and patients with cholecystolithiasis who had no previous intervention prior to LC (NPES).
Results: The PES group consists of 25 patients and the NPES group consists of 25 consecutive patients, patients in the PES group had a higher risks for longer (more than 35 min) duration of operation, the conversion rate in the PES group and the NPES group (12% versus 0%, respectively) were not significantly different, duration of post-operative hospital stay in the PES group was longer than NPES group, there was more difficulty in achieving the critical view of safety in the PES group (easily achieved in 48%) than NPES group(easily achieved in 92%).
Conclusion: A laparoscopic cholecystectomy after ES is longer and more difficult than in uncomplicated cholelithiasis and should therefore be performed by an experienced surgeon.