Evaluation of the early and delayed cholecystectomy in patients with acute biliary pancreatitis
Ünal Beyazit, Fatih Taşkesen, Abdullah Böyük, Zülfü Arikanoğlu, Akın Önder, Murat Kapan, İbrahim Aliosmanoğlu, Celalettin Keleş
Dicle Üniversitesi Tıp Fakültesi, Genel Cerrahi AD, Diyarbakır, Türkiye
Purpose: We aimed to compare the results of early and late laparoscopic cholecystectomy (LC) and to investigate their effects on mortality and morbidity in patients with acute biliary pancreatitis (ABP).
Patients and Methods: One hundred eight patients, who underwent LC with the diagnosis of moderate acute pancreatitis in our clinic between January 2005 and September 2010 were enrolled in this study. The demographic characteristics, type of surgery, operation time, rate of conversion to open surgery, complications, mortality and hospital stay were recorded.
Results: The number of the patients was 46 in group A and 62 in group B. The distribution of women and men were 76.1% / 23.9% in group A and 71.0% / 29.0% in group B, respectively. LC was performed successfully in 43 (93.5%) patients in group A and in 58 patients in group B. We had to perform open surgery in 3 (6.5%) patients in group A and 4 (6.4%) patients in group B. The average operation times were 70.5 minutes in group A and 68.6 minutes in group B. The average postoperative hospital stays were 2.8 days in group A and 3.0 days in group B.
Conclusion: Early LC did not increase the rates of conversion to open surgery and biliary tract complications. On the other hand, the rate of recurrent pancreatitis attacks was higher in group B correlating with the duration of elapsed time for LC. Therefore, we recommend early LC to protect the patients from the morbidity and mortality of the recurrent attacks in the patients with mild to moderate pancreatitis.
Keywords: Acute pancreatitis, laparoscopic cholecystectomy, timing of operation