Laparoscopic cholecystectomy (LC) is the gold standard treatment for cholelithiasis.

Our study intended to evaluate whether timing of surgery is of any influence on the course of the laparoscopic cholecystectomy (LC) following Endoscopic Retrograde Cholangio-Pancreatography ERCP/Endoscopic sphincterotomy (ES) and to identify and assess various factors that can affect the outcome in these patients.

Data of 77 patients treated for choledochocystolithiasis with ERCP/ES followed by LC were reviewed. Patients were classified into four groups, group A (n = 29): LC performed within 24 hours after ERCP; group B (n = 20): LC performed after 24 hours to 7 days; group C (n = 12): LC done between 8 to 28 days; group D (n = 16): LC done after 28 days of ERCP. Primary outcome was operating time and secondary outcomes included intra- or post-operative complications, hospital stay and hospital expenses.

Mean operative time was shortest in group A (57.1 minutes) and longest in group B [63.4 (P = 0.131)]. Mean hospital stay was shortest in group A (2.1 days) and longest in group C (5.7 days) (P = 0.003). Hospital expenses were minimal in group A (P = 0.001). Male sex, serum bilirubin level, White blood cell (WBC) count, duration of ERCP/ES procedure, contracted gall bladder and large calculus size on Ultrasonography (USG) were significantly associated with primary outcome.

LC can be performed within 24 hours of ERCP/ES with favorable outcome and less expenses. Timing of LC after ERCP/ES is not significantly associated with outcome of the procedure. Male sex, serum bilirubin level, WBC count, ERCP/ES procedure duration, contracted gall bladder and large size of gall bladder calculus on imaging are significantly associated with difficulty in surgery.