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• W1978012904 abstract "Background: Current guidelines suggest that cholecystectomy should be performed within 2 weeks after resolution of an episode of biliary pancreatitis. We hypothesized that there is a high incidence of gallstone-related events (including recurrent pancreatitis) within 2 weeks of an index episode of biliary pancreatitis in the absence of cholecystectomy. Methods: Medical records of 891 consecutive patients diagnosed with acute pancreatitis at our institution from January 1995 through December 2005 were analyzed. of 436 patients who had pancreatitis of biliary etiology, 281 patients underwent cholecystectomy following an episode of biliary pancreatitis (39 patients with pancreatic necrosis were excluded). These patients were allocated in the two groups: group A patients underwent cholecystectomy during index admission (during which pancreatitis was diagnosed, n=162). Group B patients underwent cholecystectomy following discharge from index admission (n=119). Incidence (and timing) of gallstone-related events including recurrent pancreatitis, total length of hospital stay (index admission + admissions for recurrences and cholecystectomy), and postoperative morbidity and mortality rates were analyzed. Results: Groups were comparable in demographic variables, comorbidity rates, and disease severity. Thirty-nine (32.8%) group B patients experienced gallstone-related events (including 16 cases of recurrent pancreatitis) following discharge from index admission but prior to cholecystectomy. 12.5% of recurrences occurred within 1 week, 37.5% occurred within 2 weeks and 50% occurred within 4 weeks after discharge. Endoscopic sphincterotomy (ES) protected against preoperative recurrent pancreatitis but was associated with higher rates of other biliary events. Median total length of hospital stay was greater for group B than for group A (7 [range, 2-37] days vs. 5 [1-45] days, p=0.00). Postoperative recurrence and reoperation were more frequent for group B than for group A (10.1% vs. 3.1%, p=0.02 and 0% vs.3.4%, p=0.02, respectively). There were no mortalities in either group. Conclusion: Current guidelines suggesting the appropriateness of waiting up to 2 weeks for cholecystectomy following recovery from biliary pancreatitis may place patients at unacceptably high risk for recurrence. ES does not eliminate the need for cholecystectomy in these patients." @default.
• W1978012904 created "2016-06-24" @default.
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• W1978012904 date "2008-02-01" @default.
• W1978012904 modified "2023-09-27" @default.
• W1978012904 title "119. Timing of Cholecystectomy for Biliary Pancreatitis: Do the Data Support Current Guidelines?" @default.
• W1978012904 doi "https://doi.org/10.1016/j.jss.2007.12.135" @default.
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