Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 14, 2011; 17(14): 1844-1847
Published online Apr 14, 2011. doi: 10.3748/wjg.v17.i14.1844
Role of ERCP in the era of laparoscopic cholecystectomy for the evaluation of choledocholithiasis in sickle cell anemia
Hussain Issa, Ahmed H Al-Salem
Hussain Issa, Department of Internal Medicine, King Fahad Specialist Hospital, Dammam, Qatif 31911, Saudi Arabia
Ahmed H Al-Salem, Department of Pediatric Surgery, Maternity and Children Hospital, Dammam, Qatif 31911, Saudi Arabia
Author contributions: Issa H collected the data for the manuscript and was involved in writing and editing the manuscript; Al-Salem A H analyzed the data and was involved in writing and editing the manuscript.
Correspondence to: Dr. Ahmed H Al-Salem, Department of Pediatric Surgery, Maternity and Children Hospital, PO Box 61015, Qatif 31911, Saudi Arabia. ahsalsalem@hotmail.com
Telephone: +966-505818009 Fax: +966-3863009
Received: July 15, 2010
Revised: August 6, 2010
Accepted: August 13, 2010
Published online: April 14, 2011
Abstract

AIM: To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis in patients with sickle cell anemia (SCA) in the era of laparoscopic cholecystectomy (LC).

METHODS: Two hundred and twenty four patients (144 male, 80 female; mean age, 22.4 years; range, 5-70 years) with SCA underwent ERCP as part of their evaluation for cholestatic jaundice (CJ). The indications for ERCP were: CJ only in 97, CJ and dilated bile ducts on ultrasound in 103, and CJ and common bile duct (CBD) stones on ultrasound in 42.

RESULTS: In total, CBD stones were found in 88 (39.3%) patients and there was evidence of recent stone passage in 16. Fifteen were post-LC patients. These had endoscopic sphincterotomy and stone extraction. The remaining 73 had endoscopic sphincterotomy and stone extraction followed by LC without an intraoperative cholangiogram.

CONCLUSION: In patients with SCA and cholelithiasis, ERCP is valuable whether preoperative or postoperative, and in none was there a need to perform intraoperative cholangiography. Sequential endoscopic sphincterotomy and stone extraction followed by LC is beneficial in these patients. Endoscopic sphincterotomy may also prove to be useful in these patients as it may prevent the future development of biliary sludge and bile duct stones.

Keywords: Sickle cell anemia; Cholelithiasis; Choledocholithiasis; Laparoscopic cholecystectomy; Cholangiography; Endoscopic retrogradecholangiopancreatography