EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS

Abstract

Background: Acute biliary pancreatitis and timing of cholecystectomy has always been a challenge for surgeons dealing with biliary pathology. Both the diagnosis and treatment have evolved over the last years with the introduction, and universal application of advanced imaging modalities, as well as endoscopic and laparoscopic procedures. Objective: To compare between index and interval laparoscopic cholecystectomy in the management of acute mild biliary pancreatitis. Patients and methods: This study was carried out on 50 patients with mild acute biliary pancreatitis, period from April 2020 to December 2020. The study had been carried out at Al-Hussein Hospital, Al-Azhar University, and Damanhour National Medical Institute. They were divided into two equal groups: Group A underwent early cholecystectomy within a week of admission, and group B underwent delayed (interval) cholecystectomy 4-6 weeks after discharge. Results: Early group included 3 males (12%) and 22 females (88%), while interval group included 5 males (20%) and 20 females. (80%) ,Regarding age (p=0.209) , mean age ±SD for the index group was 39.40 ± 10.46 years, and range 23 – 59 years , while in the interval group mean age ±SD was 43.40 ± 11.69 years ,and range 22 – 59 years. All cases were subjected to through history taking and complete clinical examination. Abdominal pain was the presenting symptom in all patients (100%), jaundice was present in 10cases (40%) in group A and in 8 cases (32%) in group B. Laparoscopic cholecystectomy (LC) was completed to all patients in group A and group B without conversion to open cholecystectomy. Peristalsis was audible and patients started oral fluid intake in the same day of surgery in all cases. No intraoperative complications took place, and no postoperative complications were recorded. Patients were followed for 3 months post-operatively, no mortality, and no complications were recorded. Conclusion: Laparoscopic cholecystectomy in mild acute biliary pancreatitis was safe and feasible during index admission with no added risks. Postponing cholecystectomy did not alter intra-operative complications.