ArticleThe American journal of gastroenterology2017
The Impact of Cholecystectomy After Endoscopic Sphincterotomy for Complicated Gallstone Disease.
Article in The American journal of gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Cholecystectomy outcomes after endoscopic sphincterotomy in patients with choledocholithiasis: a meta-analysis.BMC gastroenterology · 2020Pooled it
- ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis.Gastrointestinal endoscopy · 2019Guideline
- Delayed Cholecystectomy After ERCP in Geriatric Patients: Balancing Surgical Risk and Recurrence Prevention - A Retrospective Study.Clinical interventions in aging · 2025Article
- The role of cholecystectomy following endoscopic sphincterotomy and bile duct stone removal.Annals of the Royal College of Surgeons of England · 2023Article
- Safety and Feasibility of Primary Closure Following Laparoscopic Common Bile Duct Exploration for Treatment of Choledocholithiasis.World journal of surgery · 2023Article
- Laparoscopic Transcystic Common Bile Duct Exploration: 8-Year Experience at a Single Institution.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Surgical methods of treatment for cholecystolithiasis combined with choledocholithiasis: six years' experience of a single institution.Surgical endoscopy · 2022Article
- Comparative Study of the Results of Operations in Patients with Tumor and Non-Tumor Obstructive Jaundice Who Received and Did Not Receive Antioxidant Therapy for the Correction of Endotoxemia, Glycolysis, and Oxidative Stress.Antioxidants (Basel, Switzerland) · 2022Article
- The Need for Standardizing Diagnosis, Treatment and Clinical Care of Cholecystitis and Biliary Colic in Gallbladder Disease.Medicina (Kaunas, Lithuania) · 2022Review
- Article
- Clinical Impact of Preoperative Relief of Jaundice Following Endoscopic Retrograde Cholangiopancreatography on Determining Optimal Timing of Laparoscopic Cholecystectomy in Patients with Cholangitis.Journal of clinical medicine · 2021Article
- Impact of early cholecystectomy on the readmission rate in patients with acute gallstone cholangitis: a retrospective single-centre study.BMJ open gastroenterology · 2021Article
- Trends of 5-Aminosalicylate Medication Use in Patients With Crohn Disease.Inflammatory bowel diseases · 2021Article
- The Impact of Laparoscopic Cholecystectomy on 30-Day Readmission Rate for Acute Cholangitis Patients: A Single-Center Study.Digestive diseases and sciences · 2021Article
- The impact of empiric endoscopic biliary sphincterotomy on future gallstone-related complications in patients with non-severe acute biliary pancreatitis whose cholecystectomy was deferred or not performed.Surgical endoscopy · 2019Article
- The Etiology of Pancreatic Manifestations in Patients with Inflammatory Bowel Disease.Journal of clinical medicine · 2019Review
- Pancreatic function following post-endoscopic retrograde cholangiopancreatography pancreatitis: A controlled cohort study with long-term follow-up.United European gastroenterology journal · 2018Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCholecystectomy after endoscopic sphincterotomy (ES) is associated with improved outcomes compared to ES alone, however randomized trials have included mainly fit surgical candidates. Our objective was to assess the impact of cholecystectomy after ES among elderly patients, in whom the perceived risks of surgery may be increased and the prevailing bias may be to defer cholecystectomy.
methodsWe performed adjusted analyses comparing clinical outcomes in patients ≥65 years of age who did and did not undergo follow-up cholecystectomy after endoscopic sphincterotomy for choledocholithiasis, ascending cholangitis, or gallstone pancreatitis. We also compared adverse events between the two groups.
resultsIn the ES alone group, 39.3% of patients experienced a recurrent complication compared with 18.0% in the ES and cholecystectomy group. After adjusting for comorbidities using multivariable regression, cholecystectomy in addition to ES was associated with a reduced risk of recurrent choledocholithiasis (OR 0.38, 95%CI 0.34-0.42, P<0.001), ascending cholangitis (OR 0.28, 95%CI 0.23-0.34, P<0.001), and gallstone pancreatitis (OR 0.35, 95%CI 0.24-0.49, P<0.001) compared to ES alone. This benefit was preserved after propensity score adjustment, in patients ≥75 years of age, and in those with major comorbidities including cancer, heart failure, and liver disease. Serious post-operative complications such as myocardial infarction, pulmonary embolism, and pneumonia were not more common in the cholecystectomy group.
conclusionsAmong older patients, including those with serious comorbidities, cholecystectomy after endoscopic sphincterotomy was associated with a significant and clinically important reduction in recurrent complications compared to sphincterotomy alone. This benefit did not appear to be outweighed by surgical complications, highlighting the importance of cholecystectomy, even in elderly patients whose lifespans may be limited by unrelated conditions.
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