title: Mild acute biliary pancreatitis vs cholelithiasis: are there differences in the rate of choledocholithiasis?
abstract: The rate of choledocholithiasis at the time of elective surgery after mild acute biliary pancreatitis is still unclear because it decreases rapidly after the onset. The aims of this study are as follows: (1) To investigate whether the incidence of choledocholithiasis in mild biliary pancreatitis is higher than in patients with symptomatic cholelithiasis. (2) To evaluate the usefulness of intraoperative cholangiography in the diagnosis of unsuspected choledocholithiasis in mild pancreatitis. Prospective study including 130 patients undergoing laparoscopic surgery and classified into two groups: mild biliary pancreatitis (n = 44) and symptomatic cholelithiasis (n = 86). Choledocholithiasis was evaluated by endoscopic cholangiopancreatography, magnetic resonance, and intraoperative cholangiography. Preoperatively, choledocholithiasis was identified in five patients with symptomatic cholelithiasis and two with biliary pancreatitis (5.81 vs 4.54%; p = 0.472). In 117 cases (90%), intraoperative cholangiography was successfully performed, identifying unsuspected choledocholithiasis in five patients of the colelithiasis group and in three in the group of pancreatitis (5.81 vs 6.81%; p = 0.492). The total number of patients with choledocholithiasis in the whole series was 15 (11.5%); 11.6% in colelithiasis group vs 11.4% in biliary pancreatitis group; p = 0.605. The rate of choledocholithiasis was not significantly different between the groups of patients with mild acute biliary pancreatitis and symptomatic cholelithiasis. Intraoperative cholangiography identified unsuspected choledocholithiasis in 6.81% of patients with mild acute biliary pancreatitis.
authors: Department of Surgery, Hospital Clinico, University of Valencia, Avda Blasco Ibañez, no. 17, 46010 Valencia, Spain.
authors: Rosa
authors: R
authors: Bertolín-Bernades
authors: Luis
authors: L
authors: Sabater-Ortí
authors: Julio
authors: J
authors: Calvete-Chornet
authors: Bruno
authors: B
authors: Camps-Vilata
authors: Norberto
authors: N
authors: Cassinello-Fernández
authors: Miguel
authors: M
authors: Oviedo-Bravo
authors: Purificación Ivorra-García
authors: PI
authors: Monco
authors: Raúl
authors: R
authors: Cánovas-de Lucas
authors: Salvador
authors: S
authors: Lledó-Matoses
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D002758:Cholangiography; D042883:Choledocholithiasis / Q000453:epidemiology / Q000209:etiology; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012720:Severity of Illness Index