title: Cholecystectomy without intraoperative cholangiogram in gallstone pancreatitis.
abstract: OBJECTIVE
  To determine the long term outcome of cholecystectomy without intraoperative cholangiogram (IOC) in patients recovering from acute gallstone pancreatitis with normal preoperative liver function tests and imaging.
  
  
  METHODS
  The medical records of all patients who underwent cholecystectomy without IOC for gallstone pancreatitis at King Saud Medical City, Riyadh, Saudi Arabia between January 2005 and December 2009 were studied retrospectively. Patients with severe pancreatitis and those who had preoperative endoscopic retrograde cholangio-pancreatography (ERCP) were excluded from the study. Data on patients' demography, symptoms, laboratory findings, intraoperative and postoperative findings, length of hospital stay, and outpatient follow up were collected and analyzed.
  
  
  RESULTS
  A total of 160 patients were treated for acute gallstone pancreatitis. Forty-four patients with preoperative ERCP (n = 39), and severe pancreatitis (n = 5), were excluded. The remaining 116 patients initially underwent conservative treatment followed by cholecystectomy without IOC. All were followed up for an average of 2-4 visits. Five patients (4.3%) were re-admitted with gallstone related bilio-pancreatic complications. They underwent ERCP and CBD stone clearance. Four patients were lost to follow up. The remaining 107 patients have remained asymptomatic 12-55 months after cholecystectomy.
  
  
  CONCLUSIONS
  The incidence of bilio-pancreatic complications from unsuspected CBD stones in patients of biliary pancreatitis that underwent cholecystectomy without IOC is very low. Therefore, a routine IOC in these patients can be omitted safely.
authors: Department of Surgery, College of Medicine, King Saud University, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. Hamad_qah@hotmail.com
authors: Hamad H
authors: HH
authors: Al-Qahtani
authors: Mohammed K
authors: MK
authors: Alam
authors: Mohammed H
authors: MH
authors: Al-Akeely
authors: Saleh M
authors: SM
authors: Al-Salamah
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002758:Cholangiography; D002763:Cholecystectomy; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies