Biliary stones are the leading cause of acute pancreatitis.
Cholecystectomy and selective endoscopic retrograde cholangiography (ERC) comprise the current treatment in patients with acute biliary pancreatitis (ABP). However, the time of intervention is still controversial.
In this study, researchers from Turkey evaluated the outcomes of cholecystectomy on first admission for ABP, and in patients with recurrent biliary pancreatitis.
The research team retrospectively evaluated a series of 43 patients with ABP, between 1997 and 2000
- group I = 11%
- group II = 43%
|World Journal of Surgery|
They classified patients into 2 groups.
The first group (group I) included 27 patients who underwent cholecystectomy on first admission before discharge from the hospital.
While the second (group II) comprised 16 patients who had recurrent biliary pancreatitis, and then underwent cholecystectomy.
The team determined the severity of the pancreatitis by using Ranson's criteria.
For both groups, the team evaluated age, gender, length of hospital stay, severity of pancreatitis, amylase level, and complications of cholecystectomy.
Patients in group I underwent cholecystectomy during the original hospital admission and patients in group II during an admission for a recurrence.
The team found that there were 24 patients with a Ranson's score ≥ 3 in group I and 12 in group II.
In addition, mean hospital stays were 15 days and 37 days in groups I and II, respectively.
Furthermore, morbidity was 11% without mortality in group I and 43%, with 1 mortality in group II.
Dr Orhan Alimoglu's team concluded, "Definitive treatment of ABP can be accomplished effectively and safely by cholecystectomy following clinical improvement, with selective ERC performed during the first admission (delayed cholecystectomy)".
"Waiting to perform cholecystectomy (interval cholecystectomy) may result in recurrent biliary pancreatitis, which may increase morbidity and the length of the hospital stay".