TO STUDY OPTIMAL TIMING (EARLY VS DELAYED) OF LAPROSCOPIC CHOLECYSTECTOMY AFTER ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY FOR CHOLEDOCHOLITHIASIS: A RANDOMISED CONTROLLED TRIAL.

This randomized controlled study compares early versus delayed laparoscopic cholecystectomy after ERCP in patients with choledocholithiasis. ERCP clears the common bile duct, but delaying cholecystectomy may lead to recurrent biliary attacks and increased operative difficulty due to inflammation and fibrosis around Calot’s triangle. Early surgery may reduce complications, conversion to open surgery, operative time, and hospital stay. 40 patients will be randomized into early (within 4 days) and delayed (after 6 weeks) groups, with operative outcomes and complications assessed. The study aims to determine the safer and more effective timing for surgery to ensure better clinical outcomes and patient recovery.

Patients will be randomized into early and delayed groups for laparoscopic cholecystectomy, with early surgery performed within 4 days after endoscopic retrograde cholangiopancreatography and delayed surgery performed after 6 weeks in cases of cholelithiasis and choledocholithiasis.

Choledocholithiasis mostly results from gallstones passing through the cystic duct into the common bile duct. After the resolution of acute inflammation with medical treatment such as ERCP and stone removal, cholecystectomy should be performed to prevent recurrence.

The timing of surgery plays an important role. Early (within 4 days) and late (after 6 weeks) laparoscopic cholecystectomy are compared. Early surgery reduces complications seen in delayed surgery. The study compares conversion to open surgery, operative and dissection time, intraoperative complications such as bleeding, bile duct injury, gallbladder perforation, stone or bile spillage, difficulty level according to parkland grading, and the need for readmission and interval events.