To investigate the effect of cholecystectomy on reducing the recurrence of cholangitis after endoscopic retrograde cholangiopancreatography (ERCP) in patients with choledocholithiasis and cholangitis.

A retrospective analysis of one thousand cases with cholelithiasis and cholangitis admitted in Shaanxi Baoji People's Hospital from January 2010 to October 2017 was carried out. They were divided into control group (502 cases, conventional removal of bile duct stone with ERCP) and cholecystectomy group (498 cases, open or laparoscopic cholecystectomy based on the above treatment). The basic clinical data, stone situation and the recurrence of cholangitis were compared between the two groups. Cumulative relapse rate and incidence of adverse events related to cholangitis were analyzed by Kaplan-Meier method. The factors influencing recurrence of cholangitis were analyzed by univariate factor analysis and unconditional multivariate Logistic regression analysis.

There were no significant differences in basic clinical data between the two groups. Postoperative cholangitis recurred in 277 cases, including 175 cases (34.9%) in the control group, and 102 cases (20.5%) in the cholecystectomy group. The recurrence rate of cholangitis and the incidence of adverse events related to cholangitis in the cholecystectomy group were significantly lower than those in the control group (χ²=2.031, 5.035; P=0.034, 0.001). Univariate analysis and Logistic regression analysis showed that age, number of stones, maximum diameter of stones, dilatation of common bile duct, postoperative complications and cholecystectomy were independent factors for the recurrence of cholangitis (all P<0.05).

Cholecystectomy after removal of cholelithiasis by ERCP can significantly reduce the recurrence rate of cholangitis in patients with cholelithiasis and cholangitis.