Outcome of Early Cholecystectomy in Mild Biliary Pancreatitis

Abstract

Acute biliary pancreatitis (ABP) caused by gallstones and biliary sludge1 is the most important cause of Acute Pancreatitis (AP). Aim: Effect of early cholecystectomy in mild acute biliary pancreatitis. Methods: This was a hospital based observational study, by convenience sampling recruited 60 patients of mild acute biliary pancreatitis eligible as per inclusion criteria within study duration of one year reported at Department of Surgery, Sardar Patel Medical College, PBM Hospital, Bikaner. Results: mean age was 44.76±9.88 yr (range 30- 70), 60% were female, 51.67% had pain & nausea as chief complaint, 71.66% patients had Cholelithiasis on MRCP. 6.68% had 3 CT severity score preoperatively whereas 1.66% had 3 CT severity score postoperatively. 56.67% cases had surgery after 72-96 hr. Success rate of early cholecystectomy was 98.33%. 56.67% cases had surgery after 72-96 hr mean 101.6± 14.89 hr. Only one case had recurrence on 3 months follow up. Conclusion: Early Cholecystectomy for patients with acute mild gallstone pancreatitis was found to be a safe procedure when performed during the index admission. Keywords: Early Cholecystectomy; Biliary pancreatitis. Introduction Acute biliary pancreatitis (ABP) caused by gallstones and biliary sludge1 is the most important cause of Acute Pancreatitis (AP), accounting for up to 75% of cases.2 Although most cases of ABP are mild and Self-limiting, a small group (20%) of patients may develop severe pancreatitis, which is associated with high morbidity and mortality.3 Commonly, after resolution of the initial attack of APB, patients may experience a recurrent attack (40% to 60%) within 2 weeks or other gallstonerelated complications such as biliary colics, acute cholecystitis, acute cholangitis or common bile duct (CBD) obstruction. Acute pancreatitis is a common disease in the emergency room with an annual incidence rangin.