Preoperative endoscopic retrograde cholangio-pancreatography (ERCP) is a risk factor for surgical site infections after laparoscopic cholecystectomy

Thomas Peponis, Nikhil Panda, Trine G. Eskesen, David G. Forcione, Dante D. Yeh, Noelle Saillant, Haytham M.A. Kaafarani, David R. King, Marc A. de Moya, George C. Velmahos, Peter J. Fagenholz

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: We sought to examine whether preoperative endoscopic retrograde cholangio-pancreatography (ERCP) increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy. Methods: Patients admitted to an academic hospital from 2010 to 2016, who were older than 18 and had a laparoscopic or a laparoscopic converted to open cholecystectomy for complicated biliary tract disease were included. We compared those who had a preoperative ERCP to those who did not. Our primary endpoint was the rate of SSI. Results: A total of 640 patients were included. Of them, 122 (19.1%) received preoperative ERCP and 518 (80.9%) did not. The former had different preoperative diagnoses compared to non-ERCP patients (choledocholithiasis [35.2%–7.0%], acute cholecystitis [31.2%–76.4%], gallstone pancreatitis [20.5%–16.2%], and cholangitis [13.1%–0.4%], p < 0.001). The rate of SSI was higher in the preoperative ERCP group (11.5%–4.0%, p = 0.005). In a multivariable analysis conversion to open (OR = 2.57, 95% CI = 1.06–6.21, p = 0.037) and preoperative ERCP (OR = 3.12, 95% CI = 1.34–7.22, p = 0.008) were the only independent predictors of SSI. Conclusion: Preoperative ERCP is associated with a threefold increase in the risk of SSI after laparoscopic cholecystectomy.

Original languageEnglish (US)
Pages (from-to)140-144
Number of pages5
JournalAmerican journal of surgery
Volume218
Issue number1
DOIs
StatePublished - Jul 2019

Keywords

  • Endoscopic retrograde cholangio-pancreatography
  • ERCP
  • Laparoscopic cholecystectomy
  • Surgical site infection

ASJC Scopus subject areas

  • Surgery

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