title: Laparoscopy in acute biliary pancreatitis.
abstract: BACKGROUND
  The high mortality rates (20-30%) still occurring in some forms of acute pancreatitis demands adequate clinical and instrumental protocols in order to establish the most suitable therapeutic option to employ. The use of laparoscopic surgery can reduce hospital stay and time for functional recovery.
  
  
  METHODS
  The study enrolled 73 patients referring for acute biliary pancreatitis in whom staging with clinical, laboratory and instrumental criteria was performed. According to Ranson classification 63 patients (86.3%) had a mild-moderate acute biliary pancreatitis, 10 (13.6%) a severe one. In the first group laparoscopic cholecystectomy with retrograde cholangiography was performed within seven days of admission, in the second group surgical procedure followed medical treatment between eight and 30 days after the onset of the disease. No preoperative ERCP was performed.
  
  
  RESULTS
  The rate of main biliary tract calculosis was 8.2% in group A: six cases all treated through laparoscopy. Two switches (2.7%) due to intolerance to the pneumoperitoneum, eight major postoperative complications (10.9%), and two deaths (2.7%) occurred and a mean hospital stay of 7.4 days was observed in group A versus 8.2 days in group B.
  
  
  CONCLUSIONS
  The management suggested in this study for mild-moderate acute biliary pancreatitis showed consistent results with those of the recent literature, as far as morbidity (6.3%) and mortality (1.5%) are concerned. A higher number of severe biliary pancreatitis (10 cases) should be observed to assess the role of ERCP with endoscopic sphincterotomy rather than laparoscopic or combined treatment.
authors.affiliation: Laparoscopic Center of Barcelona, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Ballesta Lopez
authors.forename: R
authors.initials: R
authors.lastname: Ruggiero
authors.forename: I
authors.initials: I
authors.lastname: Poves
authors.forename: C
authors.initials: C
authors.lastname: Bettonica
authors.forename: E
authors.initials: E
authors.lastname: Procaccini
authors.forename: E
authors.initials: E
authors.lastname: Iervolino
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000601:surgery*