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Ulus Travma Acil Cer · Nov 2017
Early laparoscopic cholecystectomy following acute biliary pancreatitis expedites recovery.
- Seracettin Eğin, Metin Yeşiltaş, Berk Gökçek, Hakan Tezer, and Servet Rüştü Karahan.
- Department of General Surgery, Okmeydanı Training and Research Hospital, İstanbul-Turkey. seracettin_egin@hotmail.com.
- Ulus Travma Acil Cer. 2017 Nov 1; 23 (6): 495-500.
BackgroundIn this retrospective study, we aimed to assess the reliability of early cholecystectomy, risk of recurrent biliary pancreatitis, and their effects on hospital length of stay and morbidity by comparing the results of early and late laparoscopic cholecystectomy in patients with acute biliary pancreatitis.MethodsA total of 131 patients, who were diagnosed with acute biliary pancreatitis at Okmeydanı Education and Research Hospital in January 2009-December 2012, were included in the study. Demographic specifications of patients, duration of their complaints, biochemistry and hemogram values at first arrival, Ranson criteria, number of attacks, screenings, operation type and period, number of days between the first attack and operation, hospital length of stay, and complications were recorded. Patients who underwent cholecystectomy within the first 2 weeks were considered early (group 1) and those who under the operation after 2 weeks were considered late (group 2).ResultsThere were 47 patients in group 1 and 84 patients in group 2. Open surgery was not performed on any patient, and there was no choledoch injury and mortality. The average hospital length of stay was 7.6±3.0 days in group 1 and 10.7±8.3 days in group 2, with a statistically significant difference between the groups (p=0.006). Two or more number of attacks occurred in 15 patients in group 2 (18%), with a statistically significant difference between the groups (p=0.000).ConclusionLaparoscopic cholecystectomy is safe as it does not increase operation time and morbidity in biliary pancreatitis with a Ranson score of ≤3 or cause difficulty in dissection. Late cholecystectomy causes recurrent attacks and increases the hospital length of stay and treatment costs. Using randomized controlled studies, the effectiveness and reliability of early cholecystectomy in mild and moderate biliary pancreatitis can be verified.
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