• Armando S Muñoz Abraham, Hector Osei, Adam Bajinting, Robert A Cowles, Jose Greenspon, Brain D Hosfield, Martin S Keller, Matthew P Landman, Hawkins Owens, Matthew P Shaughnessy, Shawn D St Peter, Joseph Sujka, Adam M Vogel, and Gustavo A Villalona.
• From the Section of Pediatric Surgery, Cardinal Glennon Children's Medical Center, Saint Louis University School of Medicine, St. Louis, MO (Muñoz Abraham, Osei, Greenspon, Willalona).
• J. Am. Coll. Surg. 2022 Mar 1; 234 (3): 352-358.

BackgroundWe aim to evaluate recurrence rates of gallstone pancreatitis in children undergoing early vs interval cholecystectomy.Study DesignA multicenter, retrospective review of pediatric patients admitted with gallstone pancreatitis from 2010 through 2017 was performed. Children were evaluated based on timing of cholecystectomy. Early cholecystectomy was defined as surgery during the index admission, whereas the delayed group was defined as no surgery or surgery after discharge. Outcomes, recurrence rates, and complications were evaluated.ResultsOf 246 patients from 6 centers with gallstone pancreatitis, 178 (72%) were female, with mean age 13.5 ± 3.2 years and a mean body mass index of 28.9 ± 15.2. Most (90%) patients were admitted with mild pancreatitis (Atlanta Classification). Early cholecystectomy was performed in 167 (68%) patients with no difference in early cholecystectomy rates across institutions. Delayed group patients weighed less (61 kg vs. 72 kg, p = 0.003) and were younger (12 vs. 14 years, p = 0.001) than those who underwent early cholecystectomy. However, there were no differences in clinical, radiological, or laboratory characteristics between groups. There were 4 (2%) episodes of postoperative recurrent pancreatitis in the early group compared with 22% in the delayed group. More importantly, when cholecystectomy was delayed more than 6 weeks from index discharge, recurrence approached 60%. There were no biliary complications in any group.ConclusionsCholecystectomy during the index admission for children with gallstone pancreatitis reduces recurrent pancreatitis. Recurrence proportionally increases with time when patients are treated with a delayed approach.Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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