Mild To Moderate Acute Gallstone Pancreatitis: A Comparative Study of Early Versus Delayed Cholecystectomy

Surrendar Dawani, Aruna Dawani, Maha Khalid, Mansab Ali, Zahid Mehmood, Salman Jafferi, Shahid Rasul

Abstract

Objective

To compare the duration of surgery, conversion rate, perioperative complications, hospital stay and the rate of gallstone related recurrent complications for patients undergoing early versus delayed cholecystectomy after an episode of mild to moderate acute gallstone pancreatitis (AGP).

Study design

Experimental study.

Place & Duration of study

Department of General Surgery Unit 4, Jinnah Postgraduate Medical Centre Karachi and Ziauddin University Hospital Clifton Campus Karachi, from January 2017 to December 2017.

Methodology

This study included 80 patients who were randomized alternatively into an early cholecystectomy (EC) and a delayed cholecystectomy group (DC).The median time interval from diagnosis of AGP to cholecystectomy was seven days in the EC group and 28 days in the DC group. Patients in both the groups were compared for conversion rate to open surgery, perioperative complications, duration of surgery, length of postoperative hospital stay and the rate of recurrent biliary events.

Results

The conversion rate to open surgery, perioperative complication rate and the duration of surgery were higher in the EC group. However DC was associated with a higher rate of recurrent biliary events which ultimately lead to greater morbidity and hospital cost. The length of hospital stay remained similar between two groups.

Conclusion

Laparoscopic early cholecystectomy is the procedure of choice for patients admitted in the hospital with mild to moderate acute gallstone pancreatitis.

Key words

Early cholecystectomy, Acute pancreatitis, Acute gallstone pancreatitis.