Timing of laparoscopic cholecystectomy in acute pancreatitis with gallbladder stones

Abstract

Objective To evaluate the timing, feasibility and necessity of early laparoscopic cholecystectomy (LC) in management of patients with mild to moderate acute pancreatitis with gallbladder stones. Methods The clinical data of 75 patients with mild to moderate acute pancreatitis and gallbladder stones treated from September 2010 to August 2014 in our hospital were analyzed retrospectively. 32 patients underwent LC within 48 hours of the pancreatic attack. The results were compared with those from 43 patients with delayed LC. Results All the patients were operated by experienced surgeons. There were no significant differences between the two groups in operation time, postoperative complications, intraoperative blood loss, conversion rates, white blood cell count, percentage of neutrophils and blood amylase before and after the operation (P>0.05). Patients who received delayed LC had longer hospital stay [(10.6±1.3) vs (17.1±1.8), P<0.05]. The readmission rate in patients with delayed LC was 30.2% (13/43), and most admissions occurred within 2~4 weeks of hospital discharge. In patients with early LC, one patient developed necrotic pancreatitis and died of septic shock. All the remaining patients were cured. Conclusions It is safe, feasible and necessary to perform LC within 48 h in patients with mild to moderate acute pancreatitis and gallbladder stones. Such patients have a high readmission rate and the best timing of delayed LC is within 2~4 weeks after discharge from hospital. Key words: Gallbladder stone; Pancreatitis; Cholecystectomy; Laparoscopy