THE RESULTS OF LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE BILIARY PANCREATITIS FOLLOWING SIGNS OF CLINICAL IMPROVEMENT DURING INITIAL ADMISSION
Dr. Orhan ALİMOĞLU, Dr. Ramazan ERYILMAZ, Dr. Fatih DAŞIRAN, Dr. Mustafa ŞAHİN, Dr. Adem AKÇAKAYA
SSK Vakıf Gureba Eğitim Hastanesi 1. Cerrahi Servisi, İstanbul
The aim of this study was to evaluate the results of delayed (following signs of clinical improvement during initial admission) laparoscopic cholecystectomy (LC) in acute biliary pancreatitis (ABP). Although cholecystectomy is recommended for prevention of further attacks of ABP, LC in the treatment of ABP is contraversial due to technical difficulty.
The data of this retrospective study is obtained from the medical records of patients who admitted to our surgical department from January 1997 to December 2003. Diagnostic criteria were specified according to the the history, clinical examination, biochemical and radiological findings. Following selective ERC, patients underwent LC after clinical and biochemical resolution of attack. Age, gender, biochemical, ERC and radiological findings, conversion rate to laparotomy, operating time, intraoperative and postoperative morbidity and mortality rates, and time of hospital stay were evaluated.
There were 55 patients (45 females, 10 males) with a median age of 54 (1 7-76) years. The procedure was converted to open surgery in 7 (13%) patients. Median operating time was 60 (20-140) min.The overall morbidity rate was (11%) 6 patients. Median preoperative hospital stay time was 14 (5-17) days and postoperative stay time was 1 (1-4) days. There was no mortality.
Although conversion rate to open surgery is high, delayed laparoscopic cholecystectomy can be performed safely in patients with acute biliary pancreatitis following signs of clinical improvement during initial admission.
Keywords: Acute biliary pancreatitis, laparoscopic cholecystectomy