Biliary pancreatitis. Operative outcome with a selective approach.
To evaluate the efficacy of a selective approach to biliary pancreatitis, we reviewed the outcomes in 276 consecutive patients undergoing operations for this diagnosis during a 7-year period. Initial conservative therapy resulted in elective operations in 63% and urgent operations in 37%. Only 10 patients (3.6%) required primary pancreatic operations, 50% of them as emergencies. The proportion of common duct surgical explorations fell from 70% of those operated immediately after hospital admission to 20% by the third hospital day. Overall mortality was 1.8% but was increased to 30% in patients having an initial pancreatic operation. We conclude that a selective approach to biliary pancreatitis allows the operation to be performed electively in most patients and is associated with a low mortality and an acceptable length of stay. Most common duct stones pass spontaneously permitting cholecystectomy alone.
Schwesinger
W H
WH
Department of Surgery, University of Texas Health Science Center (UTHSC), San Antonio 78284-7842.
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Sirinek
K R
KR
Levine
B A
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Aust
J B
JB
D000208:Acute Disease; D000328:Adult; D002763:Cholecystectomy / Q000401:mortality; D002769:Cholelithiasis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D042882:Gallstones / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010195:Pancreatitis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D011446:Prospective Studies