Comparative Outcomes of Early Versus Late Laparoscopic Cholecystectomy Following ERCP in Patients with Cholelithiasis and Choledocholithiasis: A Prospective Randomized Controlled Study

Background: Cholelithiasis with coexisting choledocholithiasis presents a common clinical challenge. While endoscopic retrograde cholangiopancreatography (ERCP) is widely accepted for the management of common bile duct (CBD) stones, the optimal timing for subsequent laparoscopic cholecystectomy (LC) remains contentious. This study aimed to evaluate and compare the outcomes of early versus late LC following ERCP in terms of hospital stay, operative time, complication rates, and overall treatment success. Material and Methods: A prospective randomized controlled trial was conducted over 18 months at TMMC&RC, Moradabad. Sixty-eight patients with cholelithiasis and choledocholithiasis who underwent successful ERCP were enrolled and randomly allocated to two groups: early LC (within 72 hours post-ERCP) and late LC (6-8 weeks post-ERCP). Patient demographics, clinical parameters, intraoperative findings, postoperative outcomes, and complication rates were analyzed and compared. Results: Both groups were comparable in terms of age and gender distribution. The mean age was 37.26 years in the early group and 36.21 years in the late group (p = 0.618). Female patients predominated in both groups (early: 85.3%, late: 88.2%). Mean total hospital stay was significantly longer in the early group (8.0 days) compared to the late group (6.26 days) (p < 0.0001). Postoperative stay did not differ significantly (early: 3.62 days, late: 3.26 days; p = 0.103). Both groups had a 100% cure rate with no conversions to open surgery or major postoperative complications. Conclusion: Early LC after ERCP is a safe and effective approach with clinical outcomes comparable to delayed surgery. While early LC leads to a longer overall hospital stay, it offers the advantage of reduced risk for recurrent biliary events and may be preferable when feasible. These findings support the adoption of early LC as a standard practice following ERCP in appropriately selected patients. Keywords: Laparoscopic cholecystectomy, ERCP, choledocholithiasis, cholelithiasis, early surgery, delayed surgery, randomized controlled trial.