TIMING OF CHOLECYSTECTOMY AFTER MILD ACUTE ANCREA
Objective: The aim of this study was to compare the outcome of early (< 2 weeks) versus delayed (>2weeks)
cholecystectomy in patients with mild to moderate biliary pancreatitis.
Methods: This was a retrospective study from March 2009 to February 2013 comprising 83 patients who underwen
early (Gp A ; < 2weeks) versus delayed (Gp B ; >2 weeks) cholecystectomy following an attack of mild biliary
pancreatitis. The primary endpoint of this study was the rate of biliary complications prior to cholecystectomy
Secondary endpoints included any major complications and length of hospital stay.
Results: Early cholecystectomy was performed on 28 patients (Gp A), with 46.43% having the procedure within 72
hours and 53.57% operated within 2 weeks. Delayed cholecystectomy was planned for 55 patients (Gp B) , 56.36%
of whom had the procedue in 2 to 6 weeks while 43.64% had surgery 6 to 10 weeks after being diagnosed with acute
pancreatitis. The two groups were found to have no significant difference regards local and systemic complications
following surgery (Gp A =4 vs Gp B =6 ; p=.39). However while awaiting cholecystectomy the patients in Gp B had
significantly more atttacks of biliary complications (Gp A =1 vs Gp B =12 ; p=.012). A median hospital stay of 4.1
days was recorded for patients in Gp A which was comparable with 3.3 days for patients in Gp B (p = .47).
Conclusion: Early cholecystectomy preferably during the course of same admission is associated with significantly
less chances of recurrent biliary attacks.
Key Words: Acute biliary pancreatitis, early cholecystectomy, recurrent biliary attacks.