Cholecystectomy For Biliary Pancreatitis Research Articles

Early versus delayed cholecystectomy in biliary pancreatitis: Experience from a Local Acute Care Surgery Unit in Saudi Arabia.

Biliary pancreatitis is a common complication of gallstones. Although most patients experience mild disease, around 20% may develop severe pancreatitis with an increased risk of serious complications during recurrent attacks. The objective of our study is to compare the surgical outcomes and length of stay for early versus delayed cholecystectomy, performed within the same admission, for mild pancreatitis in a Saudi tertiary center with an established Acute Care Surgey Unit. This retrospective cohort study included all patients who underwent cholecystectomy during the index admission for biliary pancreatitis between January 2017 and January 2020. Surgical outcomes and hospital length of stay were collected and analyzed to assess overall outcomes for early and delayed cholecystectomy groups. The early group was defined as surgery performed within 72 hours of presentation. Eighty-six patients were included and allocated to the early and delayed cholecystectomy groups. The median length of hospital stay was significantly shorter in the early cholecystectomy group (4 days, IQR 3-5) compared to the delayed group (7 days, IQR 6-9) (P < .001). There was no significant difference in operative time and postoperative complications. Early cholecystectomy for mild biliary pancreatitis appears safe and feasible and may result in a shorter hospital stay.

Readmission in acute pancreatitis: Etiology, risk factors, and opportunities for improvement

Acute pancreatitis is associated with a readmission rate ranging from 7 to 34%. Readmission rates are highest among biliary (4–37%) and alcohol-induced (2–60%) acute pancreatitis. Severe acute pancreatitis and necrotizing pancreatitis have readmission rates ranging from 20 to 75%. The most common causes of readmission include recurrent acute pancreatitis (17–45% of readmissions) and smoldering symptoms/local complications (17–38%). A number of risk scores reliably estimate risk of readmission in acute pancreatitis. Decreased rates of readmission were reported in patients that underwent same-admission cholecystectomy in biliary pancreatitis and alcohol cessation interventions in alcohol-induced pancreatitis. This review article discusses readmission in acute pancreatitis, including etiology, risk factors, and opportunities for improved patient care.

The EFFect of dietary fat content on the recurrence of pancreaTitis (EFFORT): Protocol of a multicenter randomized controlled trial

BackgroundAround 20% of patients with acute pancreatitis (AP) will develop acute recurrent pancreatitis (ARP) and 10% will progress to chronic pancreatitis. While interventions to avoid recurrences exist for the two most common causes – abstinence for alcoholic and cholecystectomy for biliary pancreatitis – the are no known preventive measures in idiopathic ARP. Though it is not included in any of the guidelines, a low-fat diet is often recommended.Our aim is to test dietary fat reduction's effect on AP recurrence in a randomized controlled setting, in order to provide high-quality evidence for the validity of such an intervention. Methods, designParticipants with at least 2 episodes of AP in the preceding 2 years of which the last episode was idiopathic will be randomized to one of two diets with different fat contents: a ‘reduced fat diet’ (15% fat, 65% carbohydrate, 20% protein) and a ‘standard healthy diet’ (30% fat, 50% carbohydrate, 20% protein; based on WHO recommendations). Participants will be followed-up for 2 years (visits will be scheduled for months 3, 6, 12, 18 and 24) during which they will receive a repeated session of nutritional guidance, complete food frequency questionnaires and data on relapse, mortality, BMI, cardiovascular parameters and serum lipid values will be collected. DiscussionThis study will determine the effect of modifying the dietary fat content on AP recurrence, mortality, serum lipids and weight loss in idiopathic cases.

A Rare Nidus for Biliary Stone Formation: Post-Cholecystectomy Clip Migration

A 54-year-old woman presented with one month of recurrent postprandial right sided and epigastric abdominal pain, associated with intermittent anorexia and vomiting. Her past medical history includes Crohn’s disease diagnosed in 1976, requiring total colectomy and end ileostomy in 1977 and small bowel resection for fibrotic stricture in 1980. A cholecystectomy for biliary pancreatitis was performed in 2004.

Indications for endoscopic retrograde cholangiopancreatography and cholecystectomy inbiliary pancreatitis.

Indications for endoscopic retrograde cholangiopancreatography and cholecystectomy inbiliary pancreatitis.

Indications and Timing of ERCP and Cholecystectomy for Biliary Pancreatitis

급성 담석성 췌장염에서는 췌장염의 ì¼ë°˜ì ì¸ 치료에 더하여, 재발성 담석성 췌장염을 비롯한 담석에 의한 합병증을 줄이기 위해 ë‚´ì‹œê²½ì  역행성 담췌관 ì¡°ì˜ìˆ ê³¼ ë‹´ë‚­ì ˆì œìˆ ì„ 반드시 ê³ ë ¤í•´ì•¼ 한다. 담석성 췌장염에 담관염이 동반되어 있거나 ëª ë°±í•œ 담도폐쇄의 증거가 있는 경우 24-72시간 이내에 시행하는 조기 ë‚´ì‹œê²½ì  역행성 담췌관 ì¡°ì˜ìˆ ì´ 필요하다. 담관염은 없으나 담도폐쇄가 의심되는 경우엔 불필요한 ë‚´ì‹œê²½ì  역행성 담췌관 ì¡°ì˜ìˆ ì„ 피하기 위하여, 보다 덜 ì¹¨ìŠµì ì¸ 검사 방법인 내시경초음파나 ìžê¸°ê³µëª ë‹´ì·Œê´€ ì¡°ì˜ìˆ ì„ ìš°ì„ ê³ ë ¤í•´ ë³¼ 수 있다. ë‹´ë‚­ì ˆì œìˆ ì˜ 경우 담석성 췌장염의 중증도에 따라 ìˆ˜ìˆ ì‹œì ì„ 달리하는 ì „ëžµì´ 필요하다. 경증의 담석성 췌장염의 경우, 초기 ìž ì›ì‹œì— ë‹´ë‚­ì ˆì œìˆ ì„ ì•ˆì „í•˜ê²Œ ì‹œí–‰í• ìˆ˜ 있다. 중등도 이상의 췌장염에서는 활동성 염증반응이 가라앉은 뒤에, 특히 ê°€ì„±ë‚­ì¢ ì´ë‚˜ 체액 ê³ ìž„ì´ 있는 경우 약 6주 뒤로 ë‹´ë‚­ì ˆì œìˆ ì„ 미루어 시행하는 것이 이환율 감소에 ìœ ë¦¬í•˜ë‹¤. ë‹´ë‚­ì ˆì œìˆ ì„ 받기에 ë¶€ì ì ˆí•œ 환자에서는 내시경 ê´„ì•½ê·¼ì ˆê°œìˆ ì´ 재발성 췌장염을 줄이는데 도움이 ë ìˆ˜ 있다. 그러나 내시경 ê´„ì•½ê·¼ì ˆê°œìˆ ì„ 시행한 환자의 경우에도 ë‹´ë‚­ì ˆì œìˆ ì„ 추가로 시행하는 것이 재발성 췌장염의 위험을 더욱 감소시키므로 가능하다면 ë‹´ë‚­ì ˆì œìˆ ì„ 시행하는 것이 추천된다. Keywords: 담석성 췌장염, ë‚´ì‹œê²½ì  역행성 담췌관 ì¡°ì˜ìˆ , ë‹´ë‚­ì ˆì œìˆ , ì ì‘ì¦, ì‹œì 

A case of hospital-acquired GNB infection - P. aeruginosa meningoencephalitis post laparoscopic cholecystectomy for biliary pancreatitis, complicated with portal vein branch thrombosis and intracerebral ischemic and hemorrhagic lesions

Case report We present the case of a female patient admitted to our clinic with a suspicion of acute bacterial meningoencephalitis, one month after a laparoscopic cholecystectomy. During the first 48 hours she presented generalized seizures, 5-6 daily, with a duration that ranged from 30 to 60 seconds, that responded to medical therapy. The CSF cultures and the pulmonary tract secretions both tested positive for P. aeruginosa. The antibiotic regimen consisted of iv meropenem, colistin and ciprofloxacin for 7 days, then meropenem and ciprofloxacin for 21 days. The evolution and the treatment decisions were complicated by the discovery on the cerebral MRI of bilateral frontal ischemic and hemorrhagic lesions and a portal vein branch thrombosis. The patient registered almost complete cognitive and motor recovery, and is continuing the kinetotherapy.

Don't Delay Cholecystectomy in Biliary Pancreatitis

Don't Delay Cholecystectomy in Biliary Pancreatitis

Urgent ERCP and early elective laparoscopic cholecystectomy in biliary pancreatitis

Urgent ERCP and early elective laparoscopic cholecystectomy in biliary pancreatitis