Early or delayed laparoscopic cholecystectomy after endoscopic sphincterotomy for combined choledochocystolithiasis. A prospective randomised trial.

This is a randomised trial among patients who are scheduled to undergo laparoscopic cholecystectomy after endoscopic sphincterotomy for combined choledochocystoloithiasis. Nowadays, in most countries, surgery is planned 6 to 8 weeks after sphincterotomy. In over 20% of these patients the laparoscopic operation is converted to open surgery, whereas in patients who undergo laparoscopic cholecystectomy for uncomplicated symptomatic gallstones, conversion is necessary in only 5% of patients. The hypothesis of this trial is that the high conversion-rate in these patients can be lowered by performing the operation shortly after sphincterotomy, i.e. within 3 days. Patients who undergo successfull sphincterotommy for CBD stones, and who have residual stones in the gallbladder, will be randomised to undergo either early (within 3 days) or late (after 6-8 weeks) cholecystectomy. Primary endpoint is the number of conversions in both groups.

Early laparoscopic cholecystectomy after endoscopic sphincterotomy for combined cholecystodocholithiasis, leads to less conversions as compared to laparoscopic cholecystectomy 6-8 weeks after sphincterotomy, and thus reduces morbidity and hosptal stay.

Patients will be randomised to undergo either early (within 3 days) or late (after 6-8 weeks) cholecystectomy.