TP9.2.3Laparoscopic Cholecystectomy with Intraoperative Cholangiogram and Antegrade Biliary Stenting in Acute Gall Stone Pancreatitis: A Cohort Study

Abstract

Abstract Aims To demonstrate feasibility and efficacy of laparoscopic cholecystectomy (LC), intraoperative (IOC) and antegrade biliary stenting (ABS) as compared to selective pre-operative biliary investigation and intervention in acute gallstone pancreatitis (AGP). Methods A cohort study was performed comparing patients who had IOC+/-ABS during LC versus those who had only LC in the treatment of AGP. 74 consecutive AGP patients were included in this study from January 2016 to October 2018. All patients were included in a prospective database with follow-up for one year. Results 47 (64.5%) patients underwent IOC during LC (7 required ABS insertion), with a mean age 51 years (SEM: 2.7), 72.3% were female. The median admission bilirubin was 24 (IQR:14-54). The average number of ERCP and MRCP per patient was 0.30 and 0.15 respectively. 27 (36.5%) patients underwent LC with selective pre-operative biliary investigation with a mean age 48 years (SEM: 2.9), 66.7% were female. The median admission bilirubin was 27 (IQR:14-48). The average number of ERCP and MRCP per patient was 0.41 and 0.52 respectively. Discussion In our pilot study comparing LC with IOC versus LC with selective pre-operative biliary investigation we demonstrate that, there is marked reduction in biliary investigations required in IOC group. Length of hospital admissions and rate of post-operative complications were comparable. An analytic study with a larger cohort may demonstrate further seniority of IOC.