Timing of cholecystectomy in biliary pancreatitis treatment

Abstract

Objective: Gallstone pancreatitis constitutes 40% of all cases with pancreatitis while it constitutes up to 90% of cases with acute pancreatitis. The treatment modality in this patient population is still controversial. In this study, we aimed to compare the results of early and late cholecystectomy for patients with biliary pancreatitis.
Material and Methods: Patients treated with a diagnosis of acute biliary pancreatitis between January 2000 and December 2011 in our clinics, were reviewed retrospectively. Patients were divided into two groups: Group A, patients who underwent cholecystectomy during the first pancreatitis attack, Group B, patients who underwent an interval cholecystectomy, at least 8 weeks after the first pancreatitis episode. The demographic characteristics, clinical symptoms, number of episodes, length of hospital stay, morbidity and mortality data were recorded. All data were evaluated with Statistical Package for the Social Sciences (SPSS) 13.0 for windows and p <0.05 was considered as statistically significant.
Results: During the last 12 years, a total of 91 patients with surgical treatment for acute biliary pancreatitis were included into the study. There were 62 female and 29 male patients, with a mean age of 57.9±14.6 years (range: 21-89). A concomitant acute cholecystitis was present in 46.2% of the patients. Group A and B included 48 and 43 patients, respectively. The length of hospital stay was significantly higher in group B (9.4 vs. 6.8 days) (p<0,05). More than half of the patients in Group B were readmitted to the hospital for various reasons. Similar mortality rates were observed in both groups, one patient died due to heart failure in the postoperative period in group B.
Conclusion: In-hospital cholecystectomy after remission of acute pancreatitis is feasible. It would not only result in lower recurrence and complication rates but also shorten length of hospital stay. We recommend performing cholecystectomy during the course of the first episode in patients with acute pancreatitis.

Ethics comitee approval was not needed, as the study was retrospective.

Informed patient consent form including their treatment protocol was taken from all patients included in this study.

Externally peer-reviewed.

Concept - U.D., C.K., M.M.; Design - U.D., Ö.B.; Supervision - U.D., P.Y., H.K., M.M.; Funding - G.I., E.B.; Materials - H.K., G.I., E.B.; Data Collection and/or Processing - U.D., P.Y., G.I., E.B.; Analysis and/or Interpretation - U.D., P.Y., M.M.; Literature Review - P.Y., C.K., Ö.B.; Writer - U.D., P.Y.; Critical Review - U.D., P.Y., M.M.

No conflict of interest was declared by the authors.

The authors declared that this study has received no financial support.